title: Necrotising Candida oesophagitis after thoracic radiotherapy: significance of oesophageal wall oedema on CT.
abstract: Although oesophageal candidiasis is usually a superficial mucosal infection, necrotising Candida oesophagitis has been reported to cause oesophageal perforation or lung abscess. We report the case of an elderly Japanese man presenting with painless dysphagia after thoracic radiotherapy for oesophageal cancer. Non-contrast CT demonstrated segmental and oedematous thickening of the oesophageal wall. Endoscopy revealed white plaques on the oesophageal mucosa. The patient's oesophagitis responded to systemic antifungal therapy, and did not lead to oesophageal perforation. He died of recurrent oesophageal cancer several months later. The importance of severe radiation-induced oesophagitis without pain, our pathophysiological hypothesis on the local oedema caused by Candida infection and the usefulness of CT in evaluating abnormal thickening of the gastrointestinal tract are discussed separately in the article.
authors.affiliation: Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
authors.forename: Hirotake
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Radiology, Niigata Prefectural Central Hospital, Joetsu City, Niigata, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Sueyama
authors.affiliation: Department of Radiology, Niigata Prefectural Central Hospital, Joetsu City, Niigata, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu City, Niigata, Japan.
authors.forename: Kyuma
authors.initials: K
authors.lastname: Ota
mesh_terms: D000368:Aged; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D016629:Esophagectomy; D004941:Esophagitis / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D011859:Radiography