Clinical manifestations of oropharyngeal and esophageal candidiasis
- Carol A Kauffman, MD
Carol A Kauffman, MD
- Section Editor — Fungal Infections
- Professor of Internal Medicine
- University of Michigan Medical School
- Veterans Affairs Ann Arbor Healthcare System
Candida infections can involve local mucous membranes (eg, oropharyngitis, esophagitis, and vulvovaginitis) or be focally or systemically invasive.
Issues related to oropharyngeal and esophageal candidiasis will be reviewed here. An overview of Candida infections is presented separately. (See "Overview of Candida infections".) The treatment of oropharyngeal and esophageal candidiasis is discussed elsewhere. (See "Treatment of oropharyngeal and esophageal candidiasis".)
Oropharyngeal candidiasis, or thrush, is a common local infection seen in infants, older adults who wear dentures, patients treated with antibiotics, chemotherapy, or radiation therapy to the head and neck, and those with cellular immune deficiency states, such as AIDS [1-4]. Patients with xerostomia and those treated with inhaled corticosteroids for asthma or rhinitis are also at risk. (See "An overview of asthma management".)
The usual causative agent is Candida albicans, but other species, including C. glabrata, C. krusei, and C. tropicalis, have been isolated from cases of thrush or esophagitis [4,5]. These other species are usually present along with C. albicans, which is the probable cause of the symptoms in most patients. However, in highly immunosuppressed AIDS patients, non-albicans species appear to cause disease .
Clinical manifestations — There are two major forms of oropharyngeal candidiasis:
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