Topic Completed: 1 September 2012

Revised: 5 September 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Candida esophagitis[TI]

Elliot Weisenberg, M.D.
Page views in 2018: 3,661
Page views in 2019 to date: 3,517
Cite this page: Weisenberg E. Candida. website. Accessed October 22nd, 2019.
Definition / general
  • Usually due to Candida albicans or Candida tropicalis
  • Most common cause of infectious esophagitis
  • Associated with antibiotic use in nonimmunocompromised; also acid suppressive therapy, carcinoma, corticosteroids, diabetes mellitus, esophageal motility disorders, gastric surgery, HIV, rheumatic disease, elderly and debilitated patients (Dis Esophagus 2003;16:66)
  • Associated with CMV or HSV esophagitis in immunocompromised (see case reports below); also esophageal stricture
Clinical features
  • Patients present with dysphagia, odynophagia
  • Endoscopy: grayish white pseudomembrane or plaque in mid to distal esophagus; mucosa is erythematous, edematous, ulcerated or friable ("cottage cheese" esophagus)
  • Note: fungal invasion is a requirement for diagnosis since Candida is normal flora in GI tract
Prognostic factors
Case reports
  • Fluconazole
Gross images

Images hosted on other servers:

Focal erosion

Tan yellow
plaques with
mucosal erythema

Microscopic (histologic) description
  • Densely matted pseudohyphae and budding spores in squamous debris, fibrinopurulent exudate or necrotic debris
  • Underlying active esophagitis
  • HIV patients may have invasion into muscularis propria and adventitia if untreated (Mycoses 1997;40:81)
Microscopic (histologic) images

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Neutrophilic infiltrate



PAS staining

PAS staining

Positive stains
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