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Candida Esophagitis Presenting as an Esophageal Pseudotumor
S Taylor Frost1,2, Thaer Abdelfattah1,2, Tilak U Shah1,2
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA.
ACG Case Reports Journal
|January 5, 2023
Summary
This case study highlights a rare presentation of Candida esophagitis mimicking esophageal cancer. Higher antifungal doses were required for successful treatment, emphasizing the need for vigilance in diagnosing esophageal candidiasis.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Candida esophagitis typically presents as white plaques in the esophagus.
- Distinguishing fungal infections from malignancy is crucial for appropriate treatment.
Observation:
- A unique case of Candida esophagitis mimicked a bulky, malignant-appearing mass on endoscopy.
- The mass was avid on positron emission tomography-computed tomography (PET-CT).
Findings:
- Standard antifungal therapy (fluconazole 400 mg/day for 14 days) failed to eradicate the infection.
- Successful eradication was achieved with a higher dose of fluconazole (800 mg/day).
- Malignancy was definitively excluded through multiple biopsies and endoscopic full-thickness resection.
Implications:
- This case underscores the importance of considering atypical presentations of Candida esophagitis.
- Higher antifungal dosages may be necessary for refractory or unusually presenting esophageal candidiasis.
- Accurate diagnosis is essential to avoid unnecessary aggressive treatments for malignancy.
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