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Fungal Esophagitis in a Child with Insulin Dependent Diabetes Mellitus

Anjum Saeed1, Asaad Assiri1, Zafar Zaidi2

  • 1Department of Pediatric, King Khalid University Hospital; Saudi Arabia Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University Medical City, Riyadh, Saudi Arabia.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|August 20, 2016
PubMed

Insights

Fungal esophagitis, often seen in high-risk children with conditions like uncontrolled diabetes, requires consideration when standard treatments fail. This case highlights Candida esophagitis in an 11-year-old girl with type 1 diabetes.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Esophagitis in children is frequently linked to gastro-esophageal reflux.
  • Differential diagnoses for pediatric esophagitis include eosinophilic and infective causes.
  • Fungal (Candida) esophagitis typically affects immunocompromised or high-risk pediatric patients.

Observation:

  • An 11-year-old girl with uncontrolled type 1 diabetes presented with epigastric pain and vomiting.
  • Symptoms were unresponsive to conventional therapies.
  • Endoscopic evaluation revealed white patches and esophageal inflammation.

Findings:

  • Histopathology confirmed fungal esophagitis.
  • The patient had no dysphagia or odynophagia, and physical examination was normal.
  • Uncontrolled diabetes mellitus was a significant risk factor.

Implications:

  • Infective esophagitis, though sporadic in children, must be considered in high-risk individuals.
  • Fungal esophagitis diagnosis is crucial in pediatric patients with risk factors and refractory symptoms.
  • This case underscores the importance of considering fungal infections in pediatric esophagitis, especially in diabetic patients.

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