Esophageal candidiasis

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Background

Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.
Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.
Esophagus anatomy and nomenclature based on two systems.
  • Most commonly seen in HIV patients with CD4 count < 100 (AIDS-defining illness) or chronic inhaled glucocorticoid use

Clinical Features[1]

Differential Diagnosis

Esophagitis Types

HIV associated conditions

Evaluation

Esophageal candidiasis
  • Thick, white, linear esophageal plaques on endoscopy

Management

  • Fluconazole 400mg PO loading dose, followed by 200mg PO Qdaily x 2 weeks
  • Itraconazole 200mg PO Qdaily for 2 weeks
    • has more nausea side-effects and drug interactions compared to fluconazole

Disposition

  • Depends on ability to tolerate oral solids and liquids. Most patients will be dispositioned home with outpatient followup.

See Also

External Links

References

  1. Kauffmann CA. Overview of Candida Infections. UptoDate. 2016.
  2. Gutteridge, David L MD, MPH, Egan, Daniel J. MD. The HIV-Infected Adult Patient in The Emergency Department: The Changing Landscape of the Disease. Emergency Medicine Practice: An Evidence-Based Approach to Emergency Medicine. Vol 18, Num 2. Feb 2016.