Transnasal brush cytology for the diagnosis of Candida esophagitis in the acquired immunodeficiency syndrome

Rosario, Manuel T.; Raso, Carl L.; Comer, Gail M.; Clain, David J.

doi:10.1016/s0016-5107(89)72718-8

Cited by 9 publications

(2 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Barium swallow is generally inadequate for characterization of the infecting organism [8] (a so-called shaggy appearance has been reported with both Candida and HSV [9]), and biopsies are not possible with this diagnostic approach. However, blind brush cytology can be used in correspondence with or in lieu of other studies, with reasonable sensitivity and specificity for Candida [10,11]. On endoscopy, Candida is reported to present as isolated white or yellow plaques, with underlying mucosal erythema.…”

Section: Opinion Statementmentioning

confidence: 99%

Infectious esophagitis

Mulhall

Wong

2003

Curr Treat Options Gastro

View full text Add to dashboard Cite

Infectious esophagitis can have significant implications in an impaired host. Described most commonly in immunocompromised patients, infectious esophagitis can also occasionally be discovered in immunocompetent individuals in several unique clinical settings. Evaluation of the typical presenting complaints, such as dysphagia or odynophagia, are especially important in immunocompetent patients, and therapy should be directed at the appropriate predisposing condition and resultant infectious agent. In immunocompromised patients, however, clinical experience supports the use of empiric therapy in patients without concomitant systemic complaints. Especially in AIDS patients or those with lymphoma or leukemia, the initial approach to infectious esophagitis complaints (ie, dysphagia or odynophagia) is to begin an empiric trial of oral systemic fluconazole for presumed candidal esophagitis. If the individual remains symptomatic after 3 to 7 days or has any associated systemic complaints or concerning clinical findings (eg, hematemesis), then upper endoscopy with biopsies is indicated. If an etiologic agent other than Candida is defined by histologic, immunohistochemical, or culture methods, then appropriate therapy can be initiated. There are many important and pathologic agents implicated in infectious esophagitis. Thus, directed therapy needs to be administered appropriately and in a timely fashion to avoid poor short-term problems or long-term sequelae.

show abstract

Section: Opinion Statementmentioning

confidence: 99%

Infectious esophagitis

Mulhall

Wong

2003

Curr Treat Options Gastro

View full text Add to dashboard Cite

show abstract

“…It is well known that endoscopic biopsy can detect a malignant degeneration in Barrett's esophagus in 89.1% of cases. The incidence of Candida esophagitis is significantly increased during treatment with H2-antagonists, in scleroderma [24], and in the acquired immunodeficiency syndrome [25]. Therefore, it has been suggested that annual endoscopy and biopsy of patients with Barrett's esophagus are justified [19,20].…”

Section: Tumofsmentioning

confidence: 99%

The value of endoscopy and endosonography in the diagnosis of the dysphagic patient

1993

View full text Add to dashboard Cite

The value of endoscopy in dysphagia is limited in the diagnosis of motility disorders and small structures, webs, and hiatal hernias. Endoscopy is of special use for the clarification of an organic cause of dysphagia. Intraluminal tumors can be seen and in a high percentage of cases be definitely diagnosed by taking biopsies; a malignant degeneration in Barrett's esophagus is detectable by endoscopy in 89.1% of cases. Gastroesophageal reflux disease can be diagnosed on endoscopy as it leads to an endoscopically visible inflammatory reaction; however, normal findings on endoscopy cannot exclude reflux disease. Endoscopy is the method of choice in the diagnosis of nonreflux esophagitis, especially Candida and viral esophagitis. A further advantage of endoscopy is the fact that a microscopic diagnosis can be obtained and endoscopic treatment can be performed simultaneously. Submucosal or extramural lesions can be missed by endoscopy. Endosonography, the combination of endoscopy and ultrasonography (EUS) yields additional information in diagnosing submucosal and extramural lesions of the esophagus which is missed by other imaging procedures. One of the main advantages of EUS is the detection of small and submucosal lesions. The most important indication is the local staging of esophageal carcinomas; the accuracy of endosonography in determining the depth of infiltration ranges between 79% and 92%. The detection of paraesophageal lymph nodes is successful in 60%-82%, although EUS cannot differentiate benign from malignant lymph nodes. Submucosal tumors can be visualized by endosonography and their size, echopattern, and the layers of origin can be determined with high accuracy. Further indications for EUS are the exclusion of focal lesions in achalasia or peptic strictures.

show abstract

Esophageal Disease in Human Immunodeficiency Virus Infection

Laine

Bonacini²

1994

Arch Intern Med

View full text Add to dashboard Cite

Up to 40% of patients with the acquired immunodeficiency syndrome may develop symptoms of esophageal disease. Candida esophagitis is responsible for the majority of the cases of esophageal disease; cytomegalovirus, herpes simplex, idiopathic esophageal ulcers, and Kaposi's sarcoma account for most of the remaining cases. Although endoscopy with esophageal biopsy and brushing is the gold standard for the diagnosis of esophageal disease in the acquired immunodeficiency syndrome, we generally recommend initial empiric therapy with an antifungal agent in patients with esophageal symptoms. Since effective treatment is available for most cases of esophageal disease in the acquired immunodeficiency syndrome, we recommend endoscopic evaluation in patients who do not respond to empiric therapy within 1 to 2 weeks.

show abstract

Transnasal brush cytology for the diagnosis of Candida esophagitis in the acquired immunodeficiency syndrome

Cited by 9 publications

References 2 publications

Infectious esophagitis

Infectious esophagitis

The value of endoscopy and endosonography in the diagnosis of the dysphagic patient

Esophageal Disease in Human Immunodeficiency Virus Infection

Contact Info

Product

Resources

About