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:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Shay K, Truhlar MR, Renner RP. Oropharyngeal candidosis in the older patient. J Am Geriatr Soc 1997; 45:863.
- Epstein JB, Freilich MM, Le ND. Risk factors for oropharyngeal candidiasis in patients who receive radiation therapy for malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol 1993; 76:169.
- Iacopino AM, Wathen WF. Oral candidal infection and denture stomatitis: a comprehensive review. J Am Dent Assoc 1992; 123:46.
- Sangeorzan JA, Bradley SF, He X, et al. Epidemiology of oral candidiasis in HIV-infected patients: colonization, infection, treatment, and emergence of fluconazole resistance. Am J Med 1994; 97:339.
- Barchiesi F, Morbiducci V, Ancarani F, Scalise G. Emergence of oropharyngeal candidiasis caused by non-albicans species of Candida in HIV-infected patients. Eur J Epidemiol 1993; 9:455.
- Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol 1981; 10:65.
- Samonis G, Skordilis P, Maraki S, et al. Oropharyngeal candidiasis as a marker for esophageal candidiasis in patients with cancer. Clin Infect Dis 1998; 27:283.
- Bonacini M, Young T, Laine L. The causes of esophageal symptoms in human immunodeficiency virus infection. A prospective study of 110 patients. Arch Intern Med 1991; 151:1567.
- Darouiche RO. Oropharyngeal and esophageal candidiasis in immunocompromised patients: treatment issues. Clin Infect Dis 1998; 26:259.
- Geagea A, Cellier C. Scope of drug-induced, infectious and allergic esophageal injury. Curr Opin Gastroenterol 2008; 24:496.