Esophageal candidiasis is one of the most common gastrointestinal infections in AIDS, and its frequency varies widely. It occurs in 10 to 20 percent of patients in the United States and has been reported to occur in as many of 80 percent of patients with AIDS in developing countries. Women, in particular, may be more susceptible to esophageal candidiasis. Some studies of AIDS in women have found Candida esophagitis to be more common than Pneumocystis carinii pneumonia. Return to Contents Clinical features Candida infection of the mouth is usually easy to diagnose.
Most patients are symptomatic and complain of some oral discomfort.
Several different presentations have been described. Plaques can usually be removed by scraping, revealing the bleeding base beneath. Most patients present with vaginal itching, burning, or pain and usually complain of a vaginal discharge. Examination of the vaginal cavity usually reveals thrush, identical to that seen in the oropharynx. Patients with esophageal candidiasis develop ulcers and erosions on the esophagus and experience odynophagia or dysphagia, but as many as 40 percent of patients may have no symptoms.