Yeast infection - esophagus

Alternative names
Candida infection - esophagus; Candida Esophagitis

Definition
Candidal esophagitis is a fungal or yeast infection of the esophagus (the “food pipe” or muscular tube that carries food from the mouth to the stomach). It is caused by the yeast Candida.

Causes, incidence, and risk factors

Oral candida or thrush is an unusual finding in the young adult, although it is somewhat more common in the elderly. It often heralds a decrease in the strength of the immune system.

People with AIDS or others with compromised immune systems (organ transplant recipients, diabetics, those undergoing chemotherapy, and those with leukemia or lymphoma) are at risk for candidal infections.

Candidal esophagitis occurs when the organism spreads from the mouth down the esophagus. Swallowing becomes difficult and painful. Fever may occur if the fungus spreads further.

Oral thrush or yeast infection predisposes an immunocompromised person to esophagitis.

Symptoms

     
  • difficulty swallowing  
  • painful swallowing  
  • may have Candida in the mouth (oral thrush, with white mouth sores)

Signs and tests
Tests that show Candida include:

     
  • an EGD (esophagogastroduodenoscopy) with or without biopsy  
  • a stain or culture of esophageal brushing  
  • a throat swab culture  
  • an upper GI and small bowel series (gastrointestinal X-rays)

Treatment
The objective of treatment is to eliminate the infection with antifungal medications, such as ketoconazole and fluconazole. Amphotericin B may be used if other treatment fails.

Expectations (prognosis)
Esophagitis can usually be treated effectively. The outcome depends upon the underlying immunodeficiency that makes the person more susceptible to the infection.

Complications

     
  • recurrent infection  
  • spread of Candida to other sites  
  • holes in the esophagus

Calling your health care provider

Call for an appointment with your health care provider if symptoms of esophagitis develop, particularly if you are known to be immunosuppressed.

Prevention
Prevention of AIDS prevents opportunistic infections, such as Candida. (Opportunistic infections are infections by organisms that are not normally disease producing, but take advantage of a situation, such as a damaged immune system.) Good oral hygiene may reduce the risk of infection.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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