Candidal infection is uncommon in acute oesophagitis: evidence from a non-selected DGH population

Mucosal candida infection of the lower oesophagus is unusual except in certain groups of patients who are either immunosuppressed or who have other recognised causes of candidal infection.¹ Invasive oesophageal candidiasis occurs most often in the immunosuppressed, occurring in 10–20% of patients with myeloproliferative disorders or leukaemia and in up to 74% of patients with AIDS, with an increased frequency of infection in patients with endocrine disorders such as hypoparathyroidism.¹ Previous studies have shown that the incidence of candidal infection in 22 000 consecutive hospital admissions was 0.1% (27 cases), whereas it was found in less than 5% of a general population presenting with gastrointestinal complaints.² It is important to exclude invasive candidiasis as this is a major risk factor in the development of candidal septicaemia, which can result as a direct effect of visceral wall invasion. Complications of oesophageal candidiasis also include oesophageal stenosis and perforation, which may occur in the acute phase of infection, and which can be life threatening. Less commonly, pseudodiverticulosis may also result.¹

Candidal oesophagitis is caused most commonly by C albicans, C tropicalis, and C krusei.³ The diagnosis …