[Orointestinal candidiasis with special emphasis on esophageal candidiasis]

Area of Science:

• Medical Mycology
• Gastroenterology
• Infectious Diseases

Background:

• Oropharyngeal mycoses commonly affect the oral cavity and esophagus.
• Candida oesophagitis is increasingly recognized in intensive care unit (ICU) patients, not solely in those with AIDS.
• Risk stratification for invasive fungal infections is crucial in critically ill populations.

Purpose of the Study:

• To investigate the prevalence and characteristics of oesophageal candidosis in ICU patients.
• To correlate endoscopic findings with microscopic invasiveness.
• To assess the diagnostic value of Candida antibody detection in this patient cohort.

Main Methods:

• Upper gastrointestinal endoscopies were performed on 124 patients.
• Oesophageal and gastric candidosis were diagnosed via direct visualization and biopsy.
• Apache-II scores were used to assess patient severity.
• Serum Candida antibody levels were measured.

Main Results:

• Oesophageal candidosis was identified in 6 patients (4.8%), with 2 also having gastric Candida plaques.
• Patients with oesophageal candidosis had a higher mean Apache-II score (29.5) compared to the overall ICU group (26.7).
• A significant increase in Candida antibodies was observed in 47.6% of patients, including all with oesophageal candidosis.

Conclusions:

• Candida oesophagitis is a relevant finding in critically ill ICU patients.
• Elevated Candida antibodies may indicate infection and warrant suspicion for other Candida localizations.
• Endoscopic severity correlates with microscopic invasiveness, suggesting potential for deeper tissue involvement.