Candidal esophagitis results from overgrowth of the yeast candid albicans within the esophagus. Patients are typically elderly with chronic debilitating disease, diabetic, or immunosuppressed. Candidal esophagitis is commonly seen with late stage AIDS and in patients on immunosuppressant medication. Such patients include those undergoing chemotherapy, organ transplantation, or being treated for autoimmune diseases.
Diagnosis is made by single and double contrast barium swallow.
Radiographic findings include multiple longitudinal plaques appearing as 1-2mm in diameter filling defects with linear orientation. In fulminant esophagitis the walls of the esophagus will appear serrated and shaggy from the multiple ulcerations and pseudomembranes caused by the inflammation. This must be kept in mind if initial treatment for presumed candidal esophagitis fails. Treatment is with oral topical antifungal agents such as a nystatin swish and swallow. Complications include progression to systemic candidiasis in the predisposed patient.