monilial esophagitis

モニリア性食道炎

WordNet

1. inflammation of the esophagus; often caused by gastroesophageal reflux (同)oesophagitis
2. any of the yeastlike imperfect fungi of the genus Monilia

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/06/27 16:25:57」(JST)

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Esophageal candidiasis
Classification and external resources
Endoscopic image of esophageal candidiasis in a patient after chemotherapy. Brushings confirmed the presence of hyphae
ICD-9	112.84

Esophageal candidiasis is an opportunistic infection of the esophagus by Candida albicans. The disease usually occurs in patients in immunocompromised states, including post-chemotherapy and in AIDS. However, it can also occur in patients with no predisposing risk factors, and is more likely to be asymptomatic in those patients. It is also known as candidal esophagitis or monilial esophagitis.

Clinical presentation

Patients with esophageal candidiasis present with odynophagia, or painful swallowing. Longstanding esophageal candidiasis can result in weight loss. There is often concomittant thrush.

Some patients present with esophageal candidiasis as a first presentation of systemic candidiasis.

Diagnosis

In most cases the diagnosis is established based on response to therapy. Patients where esophageal candidiasis is suspected should receive a brief course of antifungal therapy with fluconazole. If the infection resolves after treatment with fluconazole, then the diagnosis of esophageal candidiasis is made and no further investigation is needed. However, if the infection persists or if there are other factors involved which may warrant further investigation, then patient will undergo an esophagogastroduodenoscopy if it is safe to do so. Endoscopy often reveals classic diffuse raised plaques that characteristically can be removed from the mucosa by the endsocope. Brushing or biopsy of the plaques shows yeast and pseudohyphae by histology that are characteristic of Candida species.

• A severe case of candidiasis

• H&E stain of esophagus showing Candida hyphae within the lamina propria

Therapy

The current first-line treatment is fluconazole, 200 mg. on the first day, followed by daily dosing of 100 mg. for at least 21 days total. Treatment should continue for 14 days after relief of symptoms. [Note: this page previously listed first-line treatment using a single dose of fluconazole (750mg), but that is actually treatment for oropharyngeal, not esophageal Candidiasis.] Other therapy options include:

• nystatin
• other oral triazoles, such as itraconazole
• caspofungin, used in refractory or systemic cases
• amphotericin, used in refractory or systemic cases

References

UpToDate Contents

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• 1. 口腔咽頭および食道カンジダ症の治療 treatment of oropharyngeal and esophageal candidiasis
• 2. 口腔咽頭および食道カンジダ症の臨床症状 clinical manifestations of oropharyngeal and esophageal candidiasis
• 3. 好酸球性食道炎におけるアレルギー検査 allergy testing in eosinophilic esophagitis
• 4. 好酸球性食道炎の治療 treatment of eosinophilic esophagitis
• 5. 好酸球性食道炎の臨床症状および診断 clinical manifestations and diagnosis of eosinophilic esophagitis

English Journal

• Pharmacology and metabolism of anidulafungin, caspofungin and micafungin in the treatment of invasive candidosis - review of the literature.

• Kofla G, Ruhnke M.SourceMedizinische Klinik und Poliklinik, m. S. Onkologie und Hamatologie, Charite Universitatsmedizin Berlin, Campus Charite Mitte, Chariteplatz 1, 10117 Berlin, Germany. markus.ruhnke@charite.de.
• European journal of medical research.2011 Apr 28;16(4):159-66.
• Echinocandins represent the newest class of antifungal agents. Currently, three echinocandins, anidulafungin, caspofungin and micafungin are licensed for clinical use in various indications. They act as inhibitors of β-(1,3)-glucan synthesis in the fungal cell wall and have a favorable pharmacologi
• PMID 21486730

• IL-1{beta} and ADAM17 are central regulators of {beta}-defensin expression in Candida esophagitis.

• Pahl R, Brunke G, Steubesand N, Schubert S, Bottner M, Wedel T, Jurgensen C, Hampe J, Schafer H, Zeissig S, Schreiber S, Rosenstiel P, Reiss K, Arlt A.SourceDept. of Medicine I, Univ. Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 12, 24105 Kiel, Germany. aarlt@1med.uni-kiel.de.
• American journal of physiology. Gastrointestinal and liver physiology.2011 Apr;300(4):G547-53. Epub 2011 Jan 13.
• Candida albicans resides on epithelial surfaces as part of the physiological microflora. However, under certain conditions, it may cause life-threatening infections, including Candida sepsis. We have recently shown that human β-defensins (hBDs) hBD-2 and hBD-3 are upregulated in Candida esophagitis
• PMID 21233274

Related Links

• Monilial esophagitis: an increasingly frequent cause of ...

1. Ann Thorac Surg. 1978 Oct;26(4):364-74. Monilial esophagitis: an increasingly frequent cause of esophageal stenosis? Orringer MB, Sloan H. Acute monilial esophagitis generally responds well to oral nystatin therapy, and long ...

• Monilial esophagitis. - National Center for Biotechnology ...

1. South Med J. 1975 Apr;68(4):479-80. Monilial esophagitis. Mann NS, Caplash VK. A case of monilial esophagitis, developing in a diabetic patient treated with gentamicin for Escherichia coli septicemia, is described. The ...

Related Pictures

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★リンクテーブル★

リンク元	「モニリア性食道炎」

「モニリア性食道炎」

　　[★]

英

monilial esophagitis

関

モニリア属、食道炎