Topic Completed: 1 September 2012

Minor changes: 16 June 2021

Copyright: 2003-2021,, Inc.

PubMed Search: Candida esophagitis[TI]

Elliot Weisenberg, M.D.
Page views in 2020: 6,202
Page views in 2021 to date: 7,135
Cite this page: Weisenberg E. Candida. website. Accessed September 21st, 2021.
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

Contributed by Andrey Bychkov, M.D., Ph.D. and Jijgee Munkhdelger, M.D., Ph.D.

Candida inflammatory exudate

Fungi on GMS

Spores and pseudohyphae

GMS positive fungi

Images hosted on other servers:

Neutrophilic infiltrate


PAS staining

PAS staining

Positive stains
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