Candida esophagitis: Risk factors in non-HIV population in Pakistan

Aim: Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital. Methods: Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with Candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied. Results: Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34 % of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with Candida esophagitis in 15 % patients. Conclusion: Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for Candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin.