Esophageal thrush (candida esophagitis),candida parapsilosis in urine,hematogenously disseminated candidiasis,yeast infection during pregnancy monistat - Tips For You
Author: admin, 24.10.2014Other conditions associated with an increased incidence of Candida esophagitis include esophageal stasis, alcoholism, malnutrition, and advanced age.
Occasionally, Candida esophagitis can occur in otherwise healthy individuals with no underlying esophageal or systemic disease.
Candida esophagitis results from fungal overgrowth in the esophagus, impaired cell-mediated immunity, or both. Oropharyngeal candidiasis is commonly associated with esophageal candidiasis; therefore, the presence of oral thrush may be helpful in suggesting the diagnosis of Candida esophagitis in the appropriate clinical setting.
Nevertheless, only 50-75% of patients with Candida esophagitis have oropharyngeal disease, and some patients with oropharyngeal candidiasis and dysphagia are found to have other types of esophagitis; therefore, thecorrect diagnosis cannot always be suggested on the basis of clinical presentation. Fungal overgrowth typically occurs in the setting of esophageal stasis resulting from abnormal esophageal motility (eg, achalasia or scleroderma) or mechanical causes (eg, strictures). Chronic mucocutaneous candidiasis is a congenital immunodeficiency state that is also associated with Candida esophagitis.
White plaques are present on the bucal mucosa and the undersurface of the tongue and represent thrush. Candida is commonly called thrush, and if left unchecked for a period in the mouth, it can spread to the pharynx and the esophagus and cause severe symptoms such as erosions and ulcerations of the tissues. Esophageal candidiasis, which is much more common in people with suppressed immune systems, occurs deep in the throat, and cannot always be seen during an oral examination. In its esophageal form, Candidiasis can cause chest pain, as well as pain and difficulty in swallowing.
Pill-induced esophagitisProlonged contact with certain medications can irritate the esophageal mucosa causing esophageal ulcer and esophagitis. Medication-induced esophagitis presents with sudden onset of odynophagia and retrosternal pain.
Endoscopyallows diagnostic confirmation and is a more sensitive procedurethan barium swallow [5,6].Endoscopically, pill-induced esophageal injury presents as a discrete ulcer with relatively normal surrounding mucosa.
Reflux esophagitis and Gastroesophageal reflux disease (GERD)GERDis defined as the backward passage of stomach contents through the lower esophageal sphincter.
Patients with GERD who develop Barrett esophagus tend to have a combination of clinical features, including hiatal hernia, reduced lower esophageal sphincter (LES) pressures or delayed esophageal acid clearance time. Candida esophagitis usually present as odynophagia or dysphagia.The diagnosis is based on the endoscopic picture, microscopic examination and culture of the mucosal brushings, and histological examination of the esophageal mucosa. Biopsies should be taken from the edge or margin of the ulcer where viral cytopathic effects are most likely to be present .CytomegalovirusThe most common cause of esophagitis in patients with advanced AIDS is Candida, whereas the most common viral cause is CMV. CMV esophagitis is seen in post-transplantation, long-term renal dialysis, human immunodeficiency virus (HIV) infection, and AIDS and other debilitating diseases. Esophageal diverticulumThe formation of diverticula occurs due pulsion from increased intraluminal pressure resulting in pushing of esophageal mucosa andsubmucosa through the focal weakness of mucosal wall.
When it occurs in the distal esophagus just abovethe lower esophageal sphincter, it is called epiphrenic diverticula.
Esophageal diverticula are well seen on barium x-ray examination, which is the best modalityfor diagnosis.
Esophageal rings and webs Esophageal webs are thin membrane like structure containing mucosa and submucosa which can occur anywhere in the esophagus.The patients are asymptomatic or have only intermittent dysphagia. However, esophageal webs have been described in Plummer-Vinson syndrome which present as iron deficiency anemia, glossitis and koilonychia. StrictureThe esophageal stricture is narrowing of esophagus which can be benign or malignant.The symptoms of esophageal stricture are usually insidious but progressive with dysphagia to solids followed by dysphagia to liquids. Dysphagia corresponds to the caliber of the stricture; dysphagia to solids is usually present when the esophageal lumen is narrowed to 13 mm or less. Hiatus herniaHiatus hernia refers to herniation of elements of the abdominal cavity most commonly stomach,into the mediastinum, through the esophageal hiatus of the diaphragm.Endoscopic and radiographic studies have shown a significant relation between GERD and hiatal hernia .
Hiatal hernias that are larger than 2 cm in axial span can be diagnosed easily by barium swallow radiography, endoscopy, or esophageal manometry. Dysphagia is the most common presenting symptomin patients with symptomatic benign esophageal tumors which occurs with large sized tumors.
Foreign bodies of the esophagusIngestion of foreign bodies occursmost commonly among those with psychiatric disorders, mental retardation, prisoners, and alcoholics.Thepresence of esophageal stricture or ring predispose to impaction of foreign body or food bolus in the esophagus. Esophageal Varices Varices are dilated veins which develop in the esophagus and stomach due to portal hypertension.
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