title: Candida esophagitis complicated by an esophago-airway fistula: report of a case.
abstract: Candida esophagitis rarely involves life-threatening complications, such as necrosis, perforation, or fistula formation between the esophagus and the airway. We herein report a case of Candida esophagitis complicated by esophagobronchial and esophagopulmonary fistulas. The patient in our study was a 70-year-old man with a 3-month history of dysphagia. Based on endoscopy and histological findings, he was diagnosed with a coinfection of Candida spp. and herpes simplex virus. Antifungal and antiviral therapy was administered without success. The esophagopulmonary fistula formation and a lung abscess were identified 7 months later. The patient was deemed intolerable to an esophagectomy due to his poor general condition, thus necessitating a two-stage operation. A cervical esophagostomy and a tube drainage of the thoracic esophagus were followed by an esophageal bypass using the pedicled jejunum via an antethoracic route. Although the lung abscess resolved, the inflammation of the esophagus persisted. A fistula between the esophagus and the left main bronchus eventually formed postoperatively and the patient died due to respiratory failure.
authors.affiliation: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Kanzaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Ko
authors.initials: K
authors.lastname: Takachi
authors.forename: Shingo
authors.initials: S
authors.lastname: Ishiguro
authors.forename: Masaaki
authors.initials: M
authors.lastname: Motoori
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.forename: Isao
authors.initials: I
authors.lastname: Miyashiro
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Shingi
authors.initials: S
authors.lastname: Imaoka
mesh_terms: D000368:Aged; D001980:Bronchi / Q000601:surgery*; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001999:Bronchoscopy; D002177:Candidiasis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D003937:Diagnosis, Differential; D004937:Esophageal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004941:Esophagitis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D004945:Esophagoscopy; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D008297:Male