Esophageal, gastric, and intestinal candidiasis

Gastrointestinal Candida infection is more prevalent than previously recognized. It is most often seen in patients with underlying impairment of the immune system but may also occur in apparently normal individuals. Esophageal involvement is most common, presenting with odynophagia, dysphagia, or bleeding. Gastric Candida infection may cause diffuse mucosal involvement or focal invasion of benign gastric ulcers. Intestinal candidiasis is uncommon and poorly characterized. The diagnosis is usually established by visualizing the characteristic yeast or mycelial forms in endoscopic brushings and biopsies. Oral nystatin is effective therapy in many patients, but other antifungal agents may be needed in extensive or persistent disease, especially in immunocompromised patients.