[Esophageal candidiasis in AIDS. Clinical, endoscopic, and histopathologic analysis of 19 cases]

From May 1988 to December 1989, fiberoptic endoscopy of the upper digestive tract was performed in 53 patients with AIDS. In 19 cases a presumptive diagnosis of candida esophagitis was made: 13 were men and six women; the median age was 38.9 years. The Kodsi grading scale was used to evaluate the extent of the fungal colonization. In five patients no symptoms were found, eight did not show oral candidiasis; dysphagia in seven cases and odynophagia in five cases were the main esophageal complaints. Eleven cases showed pan-esophagitis, but three cases showed only the distal portion involvement. Grade II lesions were observed in ten patients, and four had grades I or III. No correlation was found between the symptoms and the grade score. Direct brushing cytology of the esophageal lesions corroborated the endoscopic diagnosis. Association with other opportunistic infections were detected only in one case. Our findings corroborates the usefulness of the fiberoptic esophageal endoscopy to improve the diagnosis of AIDS-related esophageal candidiasis in patients without symptoms or oral lesions.