What is the pathophysiology of fungal esophagitis?

Updated: May 28, 2020
  • Author: Deepika Devuni, MD; Chief Editor: BS Anand, MD  more...
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Answer

Candida esophagitis results from fungal overgrowth in the esophagus, impaired cell-mediated immunity, or both.

Fungal overgrowth typically occurs in the setting of esophageal stasis resulting from abnormal esophageal motility (eg, achalasia or scleroderma) or mechanical causes (eg, strictures). Impaired cell-mediated immunity can result from immunosuppressive therapy (eg, with steroids or cytotoxic agents, which may suppress both lymphocyte function and granulocyte function), malignancy, or acquired immunodeficiency syndrome (AIDS). Chronic mucocutaneous candidiasis is a congenital immunodeficiency state that is also associated with Candida esophagitis.

Illnesses that interfere with esophageal peristalsis, such as achalasia, progressive systemic sclerosis, and esophageal neoplasias, may contribute to fungal esophagitis.


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