Esophagitis: The Daily PANCE Blueprint

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Esophagitis: The Daily PANCE Blueprint

A 36-year-old male with a history of HIV presents with a 1-week history of odynophagia, dysphagia, and a low-grade fever. An upper endoscopy shows white, plaque-like lesions on the esophageal mucosa. What is the most likely diagnosis?

A. Herpes simplex esophagitis
B. Cytomegalovirus esophagitis
C. Candidal esophagitis
D. Eosinophilic esophagitis
E. Reflux esophagitis

Answer and topic summary

The answer is C. Candidal esophagitis

Candidal esophagitis is irritation, inflammation, and swelling of the esophagus due to infection with Candida albicans. People with immunocompromised states (i.e., HIV infection and transplant patients) are at the highest risk for candida esophagitis. Clinical features include odynophagia, dysphagia, possibly oral thrush, fever, and chills. Diagnosis is based on endoscopic biopsy and histopathological analysis. First-line treatment for candidal esophagitis is fluconazole (oral or intravenous).

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Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ Esophageal Disorders (PEARLS) ⇒ Esophagitis

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