Esophageal Candidiasis in a Patient With Uncontrolled Diabetes Mellitus and Recurrent Abdominal Pain, Symptomatic Or Incidental? A Case Report and Brief Literature Review

Abstract

Esophageal candidiasis (EC) is a common opportunistic infection in patients with impaired cellular immunity, such as human immunodeficiency virus (HIV) infection. However, it can also be found in individuals with certain predisposing conditions like uncontrolled diabetes mellitus (DM) and the use of certain medications. We report a 54-year-old female with past medical history of DM, hypertension and hyperlipidemia who presented to the ER with worsening periumbilical and epigastric pain for 2 days. She had multiple similar presentations requiring admissions to different hospitals and had undergone extensive workup over the past year. She only had transient improvement from these hospitalizations. Esophagogastroduodenoscopy (EGD) performed on day 2 of admission revealed extensive creamy pseudomembranous exudate through the entire length of esophagus confirmed as Candida albicans by brush scraping analysis. She received oral fluconazole with significant relief of her symptoms over the next couple of weeks. Although EC remains asymptomatic in the majority of patients and is only detected incidentally on EGD, its diagnosis and treatment can provide significant symptomatic relief in many patients. EC should be considered as a potential diagnosis in the appropriate clinical setting even in patients with no evidence of overt immunodeficiency.




J Med Cases. 2015;6(11):523-526
doi: http://dx.doi.org/10.14740/jmc2337w