Candida Esophagitis
Endoscopy of Candida Esophagitis

Video Endoscopic Sequence 1 of 5.

Endoscopy of Candida Esophagitis

This 63 year-old diabetic female underwent a routine endoscopy.

Patchy white exudate scattered throughout the length of the esophagus.

Infection with Candida species is the most common type of infectious esophagitis.
Major predisposing factors include antibiotic use, radiation therapy or chemotherapy, hematologic malignancies, and AIDS.

Other conditions associated with an increased incidence of Candida esophagitis include esophageal stasis, alcoholism, malnutrition, and advanced age.
Occasionally, Candida esophagitis can occur in otherwise healthy individuals with no underlying esophageal or systemic disease.

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Endoscopy of Candida Esophagitis

Video Endoscopic Sequence 2 of 5.

Endoscopy of Candida Esophagitis

Candida esophagitis results from fungal overgrowth in the esophagus, impaired cell-mediated immunity, or both. Fungal overgrowth typically occurs in the setting of esophageal stasis resulting from abnormal esophageal motility (eg, achalasia or scleroderma) or mechanical causes (eg, strictures).

Impaired cell-mediated immunity can result from immunosuppressive therapy (eg, with steroids or cytotoxic agents), malignancy, or AIDS. Chronic mucocutaneous candidiasis is a congenital immunodeficiency state that is also associated with Candida esophagitis.




Endoscopy of Candida Esophagitis

Video Endoscopic Sequence 3 of 5.

Endoscopy of Candida Esophagitis

Whitish yeast colonies which may become confluent, and which may be associated with ulceration

Candidiasis is often asymptomatic, and may be a chance finding of no clinical significance. It can however, be the cause of odynophagia or dysphagia. It is seen commonly in the elderly and patients with immunoparesis or antibiotic therapy.

The appearance may be of small white spots, white lines, irregular yellow lines or confluent white or discoloured material.

Candida Esophagitis

Video Endoscopic Sequence 4 of 5.

Candida Esophagitis

It observes the permeation of the hifa through Esophageal epithelium.

Candida organisms are found in the superficial epitheliumlayers and inflammatory exudate, but are not easily seenon H&E-steined sections.


Candida Esophagitis

Video Endoscopic Sequence 5 of 5.

Microbiological, histological or cytological examination of the exudate is essential for accurate diagnosis.

Oropharynge-Esophagic Candidiasis.

Video Endoscopic Sequence 1 dof 5.

Oropharynge-Esophagic Candidiasis.

A 27 year-old female, HIV-positive with Colonic tuberculosis mimicking Crohn's disease, patient complained of dysphagia and odynophagia.

Candidiasis is a frequent complication for HIV-positive individual.

Candida can infect the lining of the mucous membranes in the esophagus, intestines.


Oropharynge-Esophagic Candidiasis.

Video Endoscopic Sequence 2 of 5.

Candidiasis. White plaques are present on the bucal mucosa and the undersurface of the tongue and represent thrush. When wiped off, the plaques leave red erosive areas.


Oropharynge-Esophagic Candidiasis.

Video Endoscopic Sequence 3 of 5.

The usual clinical presentation of Candida esophagitis is dysphagia and/or odynophagia in a patient with 1 or more predisposing factors for the condition.

Symptoms are variable in severity, ranging from mild difficulty in swallowing to such intense odynophagia that the patient is unable to eat or swallow saliva.

Other patients may present with chest pain or gastrointestinal tract bleeding, and occasionally, they may be asymptomatic..

Oropharynge-Esophagic Candidiasis.

Video Endoscopic Sequence 4 of 5.

Oropharyngeal candidiasis is commonly associated with esophageal candidiasis; therefore, the presence of oral thrush may be helpful in suggesting the diagnosis of Candida esophagitis in the appropriate clinical setting.

Nevertheless, only 50-75% of patients with Candida esophagitis have oropharyngeal disease, and some patients with oropharyngeal candidiasis and dysphagia are found to have other types of esophagitis; therefore, thecorrect diagnosis cannot always be suggested on the basis of clinical presentation.


Oropharynge-Esophagic Candidiasis.

Video Endoscopic Sequence 5 of 5.

This image and the video clip display esophageal
candidiasis.

Oropharynge-Esophagic Candidiasis.

Candida Esophagitis

An extensive exudate covers the mucosa.


Esophageal Candidiasis Infected with Bacteria.

Video Endoscopic Sequence 1 of 6.

Esophageal Candidiasis Infected with Bacteria.

58 year-old male, who suffers from long-standing
gastroesophageal reflux, he is not a diabetic.




Video Endoscopic Sequence 2 of 6.

There are tiny white-green elevations, thehistopathological
examination which hyphae and bacteria. are observed.

 

Video Endoscopic Sequence 3 of 6.

Gastroesophageal junction there is a hiatus hernia with
signs of reflux esophagitis and injuries caused by
candidiasis.

Video Endoscopic Sequence 4 of 6.

Retroflexion maneuver watching the tiny lesions.

Video Endoscopic Sequence 5 of 6.

 

 

Video Endoscopic Sequence 6 of 6.

 

Video Endoscopic Sequence 1 of 3.

Candida species are yeastlike fungi that can form true hyphae and pseudohyphae.

For the most part, Candid species are confined to human and animal reservoirs; however, they are frequently recovered from the hospital environment, including on foods, countertops, air-conditioning vents, floors, respirators, and medical personnel.

They are also normal commensals of diseased skin and mucosal membranes of the gastrointestinal, genitourinary, and respiratory tracts.

Video Endoscopic Sequence 2 of 3.

Candida is the fourth most common cause of nosocomial bloodstream infection in the United States.

Video Endoscopic Sequence 3 of 3

Lesions are seen in the oropharynx .


 

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