Esophageal candidiasis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Esophageal candidiasis should be differentiated from other diseases causing dysphagia especially in immunocompromised patients (e.g. herpes simplex esophagitis, CMV esophagitis)

Differentiating esophageal candidiasis from other diseases

Esophageal candidiasis should be differentiated from other diseases causing dysphagia especially in immunocompromised patients.

Prominent clinical features Endoscopy findings
Candida esophagitis
Endoscopic image of esophageal candidiasis in a patient after chemotherapy - arrows indicating the candida lesions
HSV esophagitis
  • HSV lesions are usually present in the distal esophagus. Lesions start as vesicles but later on coalesce and form large ulcers.
  • Ulcers are 8-10 mm in size, has a volcano like appearance and covered with a white exudate.
Herpes esophagitis - arrows indicating herpetic ulcers - By Donald E. Mansell, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=9666173
CMV esophagitis
Esophageal lymphoma

Candida esophagitis should also be differentiated from other less common causes of dysphagia as

References

  1. Becker K, Lübke HJ, Borchard F, Häussinger D (1996). "[Inflammatory esophageal diseases caused by herpes simplex virus infections--overview and report of 15 personal cases]". Z Gastroenterol (in German). 34 (5): 286–95. PMID 8686361.
  2. Balthazar EJ, Megibow AJ, Hulnick D, Cho KC, Beranbaum E (1987). "Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients". AJR Am J Roentgenol. 149 (5): 919–23. doi:10.2214/ajr.149.5.919. PMID 2823585.
  3. Ghimire P, Wu GY, Zhu L (2010). "Primary esophageal lymphoma in immunocompetent patients: Two case reports and literature review". World J Radiol. 2 (8): 334–8. doi:10.4329/wjr.v2.i8.334. PMC 2999330. PMID 21160688.