Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 15 January 2018, last major update September 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Candida esophagitis[TI]

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Cite this page: Weisenberg, E. Candida. website. Accessed January 17th, 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

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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