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[Orointestinal candidiasis with special emphasis on esophageal candidiasis]
1Abteilung Endoskopie/Sonographie, Ernst-Moritz-Arndt-Universität, Greifswald, Deutschland. j.berha@mail.uni-greifswald.de
Abstract:
Orointestinal mycoses are localized mainly in the oral cavity and in the oesophagus. Candida oesophagitis is not only found in AIDS-patients, also in patients of risk admitted to intensive care units. Upper intestinoscopies were made in 124 patients. Oesophageal candidosis was found in 6 patients, two of them had also Candida plaques in the stomach. The patients of the intensive care unit had an Apache-II-score of 26.7, those with Candida oesophagitis were 29.5. A significant increase in Candida antibodies was observed with 59 of 124 patients (47.6%), including all patients with oesophageal candidosis. Obviously also Candida infections of other localisations must be suspected. There was a correlation between the severity of endoscopic aspects and the invasiveness observed microscopically.
Insights
Oropharyngeal mycoses, including Candida oesophagitis, affect intensive care unit (ICU) patients. Endoscopic findings and increased Candida antibodies suggest significant infection rates and potential for systemic spread in high-risk patients.
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.