Candida esophagitis

Candida esophagitis is being increasingly recognized in the practice of clinical gastroenterology. The widespread use of corticosteroids, immunosuppressive drugs, and cancer chemotherapy, combined with the frequent use of endoscopy for the evaluation of esophageal symptoms, often leads to the identification of Candida infection in this part of the gastrointestinal tract. The salient clinical features of Candida esophagitis include odynophagia and dysphagia, although gastrointestinal bleeding may occasionally be the sole presenting symptom. While the radiological signs of Candida esophagitis are nonspecific, the endoscopic appearance is quite characteristic. Demonstration of tissue invasion by fungal mycelia on mucosal biopsy of the esophagus is diagnostic. The role of serology in the diagnosis of Candida esophagitis is not well defined. Oral nystatin therapy has been extensively used to control Candida infection of the esophagus. More recently amphotericin-B, 5-fluorocytosine and imidazole derivatives have been effectively used to treat recalcitrant cases of Candida esophagitis.