Esophageal candidoma in a patient with acquired immunodeficiency syndrome.
Oral thrush and esophagitis caused by Candida are common in patients infected with the human immunodeficiency virus. We present the case of a 33-year-old man with acquired immunodeficiency syndrome who developed dysphagia during a hospitalization for pneumonia. Signs and symptoms were consistent with Candida esophagitis. Despite therapy with fluconazole, the patient's symptoms persisted. At upper endoscopy, a 1-cm, polypoid esophageal mass at 30 cm from the incisors and several other nodular lesions were observed; white plaques were noted throughout the esophagus. Biopsy specimens of the mass contained hyphal forms consistent with Candida species. Therapy with amphotericin B improved the patient's symptoms, and resolution of the mass was confirmed by repeat upper endoscopy. We believe this is the first case in the medical literature of a Candida mass (candidoma) causing dysphagia in a patient with acquired immunodeficiency syndrome. Candidoma should be considered in the differential diagnosis of dysphagia in patients with human immunodeficiency virus infection or immunosuppression due to other causes.
Bhalodia
M V
MV
Department of Medicine, UMDNJ-New Jersey Medical School and University Hospital, Newark 07103-2714, USA.
Vega
K J
KJ
DaCosta
J
J
Trotman
B W
BW
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D000328:Adult; D002177:Candidiasis / Q000150:complications* / Q000175:diagnosis; D003680:Deglutition Disorders / Q000209:etiology; D004941:Esophagitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008297:Male