Esophageal candidiasis is an opportunistic infection of the esophagus by Candida albicans.
The disease usually occurs in patients in immunocompromised states, including post-chemotherapy and in AIDS.
However, it can also occur in patients with no predisposing risk factors.
EC patients typically present with difficult or painful swallowing.
Longstanding esophageal candidiasis can result in weight loss.
It is often associated with thrush in the mouth.
EC may be an first presentation of systemic candidiasis.
Endoscopy often reveals classic diffuse raised plaques that characteristically can be removed from the mucosa by the endoscope.
Brushing or biopsy of the plaques shows yeast and pseudohyphae by histology that are characteristic of Candida species.
The current first-line treatment is fluconazole, 200 mg. on the first day, followed by daily dosing of 100 mg. for at least 21 days total.
Treatment should continue for 14 days after relief of symptoms. Other therapy options include:
Nystatin is an effective treatment for mild esophageal candidiasis.
Oral triazoles, such as itraconazole
is used in refractory or systemic cases
Amphotericin, used in refractory or systemic cases