Not the Yeast of Our Worries: A Case of Amphetamine-Induced Esophagitis

Abstract

A 68-year-old male with active amphetamine use presented to the hospital with acute emesis, odynophagia, and mid-sternal chest pain. Imaging was initially concerning for esophageal perforation. After full evaluation including barium esophagram and serial computed tomography (CT) of the chest, no esophageal perforation was confirmed. He underwent endoscopy, which identified white, circumferential plaques along the length of the esophagus. Gross appearance on endoscopy was consistent with Candidal esophagitis. Ultimately, pathology was negative for fungal elements, and esophagitis was attributed to amphetamine use. We report a rare case of amphetamine-induced esophagitis and discuss the initial management of esophageal perforation, risk factors for, and diagnostic mimickers of Candidal esophagitis.