After the functional deficiency of host immune system or the application of antibiotics, the composition of microflora in the digestive tract changes, and the invasion ability of opportunistic pathogenic fungi is enhanced through the gene regulation mechanism, leading to opportunistic fungal infection. Under normal circumstances, both the specific defense system and the nonspecific defense system of the body's digestive tract can inhibit the excessive growth of fungi. The diagnosis of fungal esophagitis was first presented in 1839, and candida was identified as the pathogen. The occurrence of infection is the result of the interaction between pathogen and host, especially related to the immune status of the body and whether the patient has basic diseases. We have found that the incidence of EC was 0.32% in individuals with strong immunity in Korea in a single-center study. This is because approximately 10–15% of HIV-infected patients will develop EC during their lifetime, while another 85–90% of HIV-infected patients will develop oropharyngeal candidiasis. Įsophageal candidiasis (EC) is usually common among patients infected with human immunodeficiency virus (HIV). When host defense mechanisms are impaired, it allows candida to proliferate in esophageal mucosa and form adhesive plaques. Normally, candida is a symbiont of the esophagus. The most common cause of infectious esophagitis is candida infection of the esophagus, with an incidence of up to 88%. Mucosal candida infections, especially those involving oropharynx, esophagus, and vagina, are most common in the general population. The pathogenicity of these pathogens varies from species to species, and so does the degree of damage to the immune system. More than 15 distinct candida species can cause diseases, and the most common pathogens are C. When there is an impaired local or systemic immune system, candida overgrowth may occur, leading to candida infection. Except for a few complications such as necrotizing esophageal candidiasis, fistula, and sepsis, the prognosis of esophageal candidiasis has been good.Ĭandida is a yeast organism that colonizes the surface epithelium of the alimentary canal and urogenital system of healthy human beings as normal flora. It is important to differentiate esophageal candidiasis from other forms of infectious esophagitis such as cytomegalovirus, herpes simplex virus, gastroesophageal reflux disease, medication-induced esophagitis, radiation-induced esophageal injury, and inflammatory conditions such as eosinophilic esophagitis. The treatment is by systemic antifungal drugs given orally in a defined course. This disease is confirmed histologically by taking the biopsy or brushings of yeast and pseudohyphae invading mucosal cells. These adherent lesions cannot be washed off with water from irrigation. Endoscopic examination is the best approach to diagnose this disease by directly observing the white mucosal plaque-like lesions and exudates adherent to the mucosa. On physical examination, there is a plaque that often occurs together with oral thrush. Patients complained of pain on swallowing, difficulty swallowing, and pain behind the sternum. Another group includes those who used antibiotics frequently and those who have esophageal motility disorder (cardiac achalasia and scleroderma). Immunocompromised patients are most at risk, including patients with HIV/AIDS, leukemia, diabetics, and those who are receiving corticosteroids, radiation, and chemotherapy. In the gastrointestinal tract, the esophagus is the second most susceptible to candida infection, only after the oropharynx. Esophageal candidiasis (EC) is the most common type of infectious esophagitis.

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