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Infectious esophagitis in the immunosuppressed: Candida and beyond
Kais Zakharia1,2, James H Tabibian2,3
1Internal Medicine Residency Program, Department of Medical Education, Beaumont Health- Dearborn, Dearborn, MI, USA.
Journal of Community Medicine (Reno, Nev.)
|January 4, 2020
Summary
Infectious esophagitis is common in immunosuppressed patients. This case highlights a patient with autoimmune hepatitis who developed both oral and esophageal candidiasis after corticosteroid treatment, alongside herpes esophagitis.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Infection is a leading cause of esophagitis, particularly in immunocompromised individuals.
- Common pathogens include Candida, herpes simplex virus (HSV), and cytomegalovirus (CMV).
- Corticosteroid therapy can increase the risk of opportunistic infections.
Purpose of the Study:
- To review the clinical aspects of infectious esophagitis.
- To present a case of concurrent oropharyngeal and esophageal candidiasis in an immunosuppressed patient.
- To highlight the diagnostic findings of herpes esophagitis in this patient.
Main Methods:
- Clinical case review.
- Endoscopic examination.
- Histopathological analysis.
Main Results:
- The patient, with autoimmune hepatitis on high-dose corticosteroids, presented with odynodysphagia.
- Endoscopy and histopathology confirmed herpes esophagitis.
- Concomitant oropharyngeal and presumed esophageal candidiasis was also noted.
Conclusions:
- Infectious esophagitis, including herpes simplex virus and Candida, is a significant concern in immunosuppressed patients.
- Prompt diagnosis and treatment are crucial for managing these infections.
- This case underscores the importance of considering multiple pathogens in patients with compromised immunity and esophageal symptoms.
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