Esophageal candidiasis

Esophageal candidiasis
hyphae
Specialty	Infectious diseases

Esophageal candidiasis is an

People with esophageal candidiasis typically present with difficult or painful swallowing. Longstanding esophageal candidiasis can result in weight loss. There is often concomitant thrush in the mouth.

Some patients present with esophageal candidiasis as a first presentation of systemic candidiasis.

Diagnosis

In most cases, the diagnosis is established based on response to therapy. Patients in whom esophageal candidiasis is suspected should receive a brief course of antifungal therapy with

• 
• 
• 
  A severe case of candidiasis
• 
  hyphae within the lamina propria

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.^[2] It can be used as (swish, do not swallow) treatment for oral candidiasis that occurs with the use of asthma pumps.
• Suspected cases of esophageal candidiasis should be treated with short-term fluconazole antifungal therapy. When symptoms recover after therapy, we can diagnosis esophageal candidiasis and do not need more investigations.^[3] Oral fluconazole is most commonly used medication for esophageal candididasis. For patients who cannot tolerate oral medication, IV fluconazole can be used alternatively.^[3]
• Other oral
  triazoles, such as itraconazole and voriconazole can be other options.^[3]
• Amphotericin B can be used in nonresponsive cases, but should not be used routinely due to its serious side effects.^[3]
• Posaconazole is effective in severe and refractory esophageal candidiasis.^[3]

References