Naslov
Candida esophagitis : Images in Clinical Medicine

Autori
Brnčić, Nada ; Mijandrušić Sinčić, Brankica ; Višković, Ivica

Izvornik
Wiener klinische Wochenschrift (0043-5325) 117 (2005), 15/16; 520-520

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
Candida esophagitis

Sažetak
A 69-year-old, HIV-negative, diabetic male presented with vomiting, dysphagia and odynophagia of 2-week duration. He was suffering from chronic alcohol liver disease and 20 years ago he had undergone partial gastrectomy with Billroth II anastomosis. On admission he was dehydrated and anuric. WBCs were 30.9 x 109/L, urea 65.4 mmol/L, creatinine 749 μmol/L, blood glucose 21.0 mmol/L. Single-contrast barium esophagograms showed numerous small ulcerations with some larger lesions (arrows) (Fig. 1). Whitish plaques and ulcerations with several obstructing fungus formations at the cardial level were apparent on endoscopy. Esophageal varices were not observed. Thoracic CT scan was of no further diagnostic value. Intraepithelial neutrophiles, stromal mononuclear infiltrate and C. albicans spores (arrows) were present in bioptic tissue by histology (Fig. 2). The patient underwent rehydration and renal replacement therapy. Renal function was rapidly recovering and fungal infection was managed by fluconazole 100 mg bid. The regression of esophageal lesions was slow and partial with minor inflammatory changes persisting even 4 months later. Candida esophagitis is frequent in immunocompromised [1] and it has been described even in apparently immunocompetent subjects [2]. In the presented case esophageal involvement was uncommonly pronounced, protracted and somewhat resistant to therapy. The extent of fungal growth led to esophageal obstruction, dehydration and acute renal failure. Multiple predisposing risk factors including diabetes, alcoholism and previous gastric surgery were identified in this patient. The presence of multiple risk factors has been observed in the majority of patients affected by this disease, and seems to be important in its pathogenesis [3].

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA