Esophagus
Esophagitis
Candida
Author: Elliot Weisenberg, M.D.
Last author update: 1 September 2012
Last staff update: 25 September 2023 (update in progress)
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Candida esophagitis[TI]
Table of Contents
Definition / general | Etiology | Clinical features | Diagnosis | Prognostic factors | Case reports | Treatment | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stainsCite this page: Weisenberg E. Candida. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophaguscandidaesophagitis.html. Accessed September 28th, 2023.
Definition / general
- Usually due to Candida albicans or Candida tropicalis
- Most common cause of infectious esophagitis
Etiology
- 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)
Diagnosis
- Note: fungal invasion is a requirement for diagnosis since Candida is normal flora in GI tract
Prognostic factors
- Poorer prognosis in elderly (Dis Esophagus 2006;19:189)
Case reports
- 58 year old man with coexisting herpes esophagitis (Hum Pathol 1982;13:760)
- 70 year old healthy woman (Internet J Infect Dis 2005;5:1)
Treatment
- 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
GMS
PAS staining
PAS staining
