on the first day, followed by daily dosing of 100 mg. The current first-line treatment is fluconazole, 200 mg. H&E stain of esophagus showing Candida hyphae within the lamina propria Brushing or biopsy of the plaques shows yeast and pseudohyphae by histology that are characteristic of Candida species. Endoscopy often reveals classic diffuse raised plaques that characteristically can be removed from the mucosa by the endoscope. However, if the infection persists or if there are other factors involved which may warrant further investigation, then patient will undergo an esophagogastroduodenoscopy if it is safe to do so. If the infection resolves after treatment with fluconazole, then the diagnosis of esophageal candidiasis is made and no further investigation is needed. Patients in whom esophageal candidiasis is suspected should receive a brief course of antifungal therapy with fluconazole. In most cases, the diagnosis is established based on response to therapy. Some patients present with esophageal candidiasis as a first presentation of systemic candidiasis.
There is often concomitant thrush in the mouth. Longstanding esophageal candidiasis can result in weight loss. People with esophageal candidiasis typically present with difficult or painful swallowing. It is also known as candidal esophagitis or monilial esophagitis. However, it can also occur in patients with no predisposing risk factors, and is more likely to be asymptomatic in those patients. The disease usually occurs in patients in immunocompromised states, including post- chemotherapy and in AIDS. Brushings confirmed the presence of hyphaeĮsophageal candidiasis is an opportunistic infection of the esophagus by Candida albicans. Endoscopic image of esophageal candidiasis in a patient after chemotherapy.
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