Esophageal Candidiasis—An Adverse Effect of Inhaled Corticosteroids Therapy

Abstract

Over the last few decades, inhaled corticosteroids (ICs) became the cornerstone in the treatment of persistent asthma. Their use improved asthma control, decreased mortality and also minimized adverse reactions associated with systemic steroid. Esophageal candidiasis is a rare complication resulting from the use of ICs. Although, in recent years, as their prescriptions has increased, more cases have been reported, especially in Japan. Listed are 4 case reports regarding esophageal candidiasis in asthmatic patients associated with inhaled budesonide administration. In the cases reported herein, the use of a different device of dry powder budesonide might have favored esophageal drug deposition and Candida infection. Patients denied using systemic corticosteroids in the previous 6 months. Furthermore, none of the patients presented Diabetes mellitus, malignant disease, HIV infection, or other immunosuppressive conditions. We conclude that patients treated with high doses of ICs are at higher risk of developing esophageal candidiasis. These patients should undergo upper gastrointestinal endoscopy whenever they present symptoms. Nevertheless, we must keep in mind that infection might also be asymptomatic and esophageal candidiasis prevalence may be higher than that reported thus far.

Infective Esophagitis: Inhaled Steroids Treatment for Eosinophilic Esophagitis not Always Safe

“…Co-infection is common [17]. Esophageal candidiasis and herpes esophagitis due to the immunosuppressive effects of swallowed fluticasone is well reported in the literature [18][19][20]. However, to our knowledge, CMV esophagitis associated with inhaled fluticasone has not been reported so far.…”

Asthma and Oral Health in Children

“…İnhale steroidler astım tedavisinde sıklıkla kullanılan ilaçlardır (15). Ancak bu ilaçların özellikle uzun süreli kullanımında görülen bir takım yan etkileri vardır.…”

A Case of Esophageal Candidiasis in an Adolescent Who Had Frequently Received Budesonide Nebulizing Therapy

“…But some adverse effects such as dysphagia, odynophagia, retrosternal pain, and hoarseness caused by local candidal infection in the esophagus of an adult patient were reported. The most common site of local candidal infections is the oro-pharynx, but a few cases of esophageal candidiasis have been reported [2,3]. The authors report a case of esophageal candidiasis in a female, previously healthy adolescent who had frequently received nebulizer therapy with budesonide a few times just for a cough.…”