title: Fungal Esophagitis in a Child with Insulin Dependent Diabetes Mellitus.
abstract: Esophagitis in children is not uncommon, mostly due to gastro-esophageal reflux. Other conditions like eosinophilic and infective esophagitis need to be elucidated in differential diagnoses. Fungal orCandida esophagitisusually occurs in high risk children who are immune-compromised, malnourished, on steroid therapy or have uncontrolled diabetes mellitus. An eleven-year girl presented with uncontrolled type I diabetes mellitus and recurrent epigastric pain with vomiting. Her oral intake was satisfactory. There was no dysphagia and odynophagia. Physical examination was normal with good oral hygiene. Failure in responding to conventional medications led to endoscopic evaluation, which revealed white patches and esophageal inflammation and diagnosed as fungal esophagitis on histopathology. Although infective esophagitis is encountered sporadically in pediatric age group, but it should always be considered in high risk individuals and when conventional medication fails to resolve the symptoms.
authors.affiliation: Department of Pediatric, King Khalid University Hospital; Saudi Arabia Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Anjum
authors.initials: A
authors.lastname: Saeed
authors.affiliation: Department of Pediatric, King Khalid University Hospital; Saudi Arabia Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Asaad
authors.initials: A
authors.lastname: Assiri
authors.affiliation: Department of Pediatric, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Zaidi
authors.affiliation: Department of Histopathology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulmalik
authors.initials: A
authors.lastname: Alsheikh
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D002175:Candida / Q000145:classification / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D004941:Esophagitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
chemical_list: D000935:Antifungal Agents; D007328:Insulin; D015725:Fluconazole