SHM Converge Scientific Abstract ePoster Gallery-Candida Esophagitis in an Immunocompetent Patient

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Northwell Health is New York State’s largest health care provider and private employer, committed to high-quality care, medical education, research, and community service regardless of ability to pay. The document then presents a clinical case of <strong>Candida esophagitis in an immunocompetent patient</strong>.

A 58-year-old woman with prediabetes, hypertension, GERD, and prior cholecystectomy developed <strong>acute odynophagia</strong> over 3–4 days, mainly with solid food and localized to the lower chest. She denied systemic symptoms, oral complaints, smoking, recent steroid use, sexual activity, or cancer history. Her prior cancer screenings were up to date, HIV testing was negative, and the exam was largely normal except for mild epigastric tenderness. She was initially started on a proton pump inhibitor and referred for gastroenterology follow-up.

Endoscopy later showed mild esophagitis at the gastroesophageal junction and mild antral gastropathy, but biopsy revealed <strong>pseudohyphal fungal forms and lymphocytic inflammation</strong>, confirming <strong>Candida esophagitis</strong>. Repeat CBC and HIV testing were normal. She was treated with <strong>14 days of fluconazole</strong>, after which her symptoms resolved.

Key teaching points are that Candida esophagitis is the most common infectious esophagitis and is usually linked to immunocompromise, but it can also occur in <strong>immunocompetent patients</strong>, especially those using <strong>acid-suppressive therapy</strong> such as PPIs or H2 blockers like famotidine. The report suggests clinicians should consider Candida esophagitis in patients with unexplained acute odynophagia, even without immune deficiency, and treat confirmed cases with systemic antifungal therapy.

Asset Subtitle

Suhwoo S. Bae

Meta Tag

Author List Alexander Shaffer, Edward Bae, Joseph You, Kishen Bulsara MD, Michael Vaysblat, Suhwoo S. Bae, Yani Zhao

Category Clinical Vignettes

Concept Esophageal Candidiasis

Concept Antifungal Therapy

Concept Fluconazole

Concept Swallowing Impairment

Concept Odynophagia

Distinguished Non-Finalist

Presenter Organization Northwell Health

Presenting Author Suhwoo S. Bae

Track Adult

Keywords

Candida esophagitis

immunocompetent patient

odynophagia

fluconazole

endoscopy

pseudohyphal fungal forms

acid-suppressive therapy

proton pump inhibitor

gastroesophageal junction

infectious esophagitis

Esophageal Candidiasis

Antifungal Therapy

Fluconazole

Swallowing Impairment

Odynophagia