Association of Candida esophagitis with acute esophageal necrosis

Acute esophageal necrosis (AEN) is a clinical rarity and its pathogenesis is poorly understood. It usually presents as upper gastrointestinal bleeding and is associated with poor outcomes. We report a case of a 53-year-old man with diabetes and cirrhosis who presented with diabetic ketoacidosis and had an upper gastrointestinal bleed during the hospital stay from AEN associated with Candida esophagitis. In addition to the standard supportive therapy, such patients require antifungal therapy. This case underscores how a rare disease can present like a common disease and prove to be a management challenge if the differential is not kept broad.