Esophageal stricture secondary to candidiasis without underlying disease

Recurrent Candida-Associated Esophageal Strictures in an Immunocompetent Patient

Esophageal stricture due to Candida esophagitis is a rare complication reported among immunocompromised patients in only limited case reports. We describe a unique case of a 36-year-old man with chronic mucocutaneous candidiasis without underlying immunocompromise who experienced over 10 years of recurrent dysphagia due to esophageal strictures from candidiasis. His symptoms were initially believed to be due to eosinophilic esophagitis; however, numerous biopsies from the esophagus were negative for eosinophils. Several upper endoscopies, however, did reveal fungal elements consistent with Candida spp. He experienced recurring episodes of dysphagia and persistent esophageal stricture, requiring multiple antifungal courses and endoscopic balloon dilatations.

Esophageal Stricture Secondary to Candidiasis in a Child with Glycogen Storage Disease 1b

Esophageal candidiasis is commonly seen in immunocompromised patients; however, candida esophagitis induced stricture is a very rare complication. We report the first case of esophageal stricture secondary to candidiasis in a glycogen storage disease (GSD) 1b child. The patient was diagnosed with GSD type 1b by liver biopsy. No mutation was found in the G6PC gene, but SLC37A4 gene sequencing revealed a compound heterozygous mutation (p.R28H and p.W107X, which was a novel mutation). The patient's absolute neutrophil count was continuously under 1,000/µL when he was over 6 years of age. He was admitted frequently for recurrent fever and infection, and frequently received intravenous antibiotics, antifungal agents. He complained of persistent dysphagia beginning at age 7 years. Esophageal stricture and multiple whitish patches were observed by endoscopy and endoscopic biopsy revealed numerous fungal hyphae consistent with candida esophagitis. He received esophageal balloon dilatation four times, and his symptoms improved.