Esophageal candidiasis
Ba esophagogram reveals shaggy ulcerations involving the retrocardiac and epiphrenic segments of the esophagus.
Infectious esophagitis caused by fungi of candida species.
Location
Predominantly mid & upper esophagus.
often spares distal esophagus.
Imaging findings
Barium Swallow:
a. Discrete plaques in mid to upper esophagus with longitudinal orientation and intervening normal mucosa.
b. Nodular or granular mucosa.
c. Cobblestone or snake skin appearance with confluent plaques.
d. Severe: “Shaggy†esophagus usually in AIDS patients.
e. â€Foamy†esophagus.
f. Nonspecific: Earliest finding is abnormal motiliy (tertiary contractions, dilatation or atony)
g. Chronic: strictures
h. Rare: “Double barrel esophagusâ€= intramural tracts.
CT Scan
a. Uniform circumferential wall thickening (>5mm)
b. â€Target signâ€
Edematous wall shows hypodense submucosa.
Inflamed mucosal segments show avid enhancement.
Treatment
a. Oral antifungals: Ketoconazol or fluconazol.
b. Amphotericin-B for treatment failures or recurrences.