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Shahabudin S, Azmi NS, Lani MN, Mukhtar M, Hossain MS. Candida albicans skin infection in diabetic patients: An updated review of pathogenesis and management. Mycoses 2024; 67:e13753. [PMID: 38877612 DOI: 10.1111/myc.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
Candida species, commensal residents of human skin, are recognized as the cause of cutaneous candidiasis across various body surfaces. Individuals with weakened immune systems, particularly those with immunosuppressive conditions, are significantly more susceptible to this infection. Diabetes mellitus, a major metabolic disorder, has emerged as a critical factor inducing immunosuppression, thereby facilitating Candida colonization and subsequent skin infections. This comprehensive review examines the prevalence of different types of Candida albicans-induced cutaneous candidiasis in diabetic patients. It explores the underlying mechanisms of pathogenicity and offers insights into recommended preventive measures and treatment strategies. Diabetes notably increases vulnerability to oral and oesophageal candidiasis. Additionally, it can precipitate vulvovaginal candidiasis in females, Candida balanitis in males, and diaper candidiasis in young children with diabetes. Diabetic individuals may also experience candidal infections on their nails, hands and feet. Notably, diabetes appears to be a risk factor for intertrigo syndrome in obese individuals and periodontal disorders in denture wearers. In conclusion, the intricate relationship between diabetes and cutaneous candidiasis necessitates a comprehensive understanding to strategize effective management planning. Further investigation and interdisciplinary collaborative efforts are crucial to address this multifaceted challenge and uncover novel approaches for the treatment, management and prevention of both health conditions, including the development of safer and more effective antifungal agents.
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Affiliation(s)
- Sakina Shahabudin
- Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang Al-Sultan Abdullah, Kuantan, Pahang, Malaysia
| | - Nina Suhaity Azmi
- Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang Al-Sultan Abdullah, Kuantan, Pahang, Malaysia
| | - Mohd Nizam Lani
- Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | | | - Md Sanower Hossain
- Centre for Sustainability of Mineral and Resource Recovery Technology (Pusat SMaRRT), Universiti Malaysia Pahang Al-Sultan Abdullah, Kuantan, Pahang, Malaysia
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Correia AA, Weber MA, Krishnan U. Prevalence, Predictive Factors, and Clinical Manifestations of Fungal Esophagitis in Children. J Pediatr Gastroenterol Nutr 2023; 77:610-617. [PMID: 37608450 DOI: 10.1097/mpg.0000000000003927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Fungal esophagitis (FE) is the most common cause of esophageal infection and its prevalence in immunocompetent adults is rising. However, there is minimal data on FE in children without human immunodeficiency virus. Therefore, the objective of this study was to determine the prevalence, symptoms, endoscopic appearances, and predictive factors of FE in children, regardless of immune status. METHODS A 2010-2020 retrospective case-control study was conducted on 1823 children presenting to Sydney Children's Hospital for elective endoscopy with esophageal biopsy. Histopathology reports were reviewed to identify FE cases and determine prevalence rates. Thirty-two patients with FE were age- and sex-matched (1:2) to 64 controls. Significant symptoms and risk factors of FE were identified via univariate and multivariate logistic regression analysis. RESULTS The prevalence of FE in children was 1.76%. Common symptoms included dysphagia (25%), heartburn (25%), poor oral intake (21.9%), vomiting (18.8%), cough (15.6%), nausea (12.5%), and weight loss (9.4%). No significant differences in symptoms were found between cases and controls. On endoscopy, although white plaques were associated with FE ( P < 0.001), visually normal findings were reported in 28.1% of cases. Topical swallowed corticosteroids were a significant independent risk factor for FE (adjusted odds ratio = 10.740, 95% confidence interval: 1.213-95.101, P = 0.033). CONCLUSIONS The prevalence of FE in this pediatric cohort reflects rates among immunocompetent adults. Given that many of these children presented with a wide range of gastrointestinal symptoms, esophageal biopsy is required to accurately diagnose FE. Pediatricians should consider the risk of FE when prescribing topical swallowed corticosteroids.
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Affiliation(s)
- Alison A Correia
- From the Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Martin A Weber
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
- the Department of Anatomical Pathology, New South Wales Health Pathology East (Randwick Campus), Randwick, New South Wales, Australia
| | - Usha Krishnan
- the Department of Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
- the School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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3
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Kimchy AV, Ahmad AI, Tully L, Lester C, Sanghavi K, Jennings JJ. Prevalence and clinical risk factors for esophageal candidiasis in non-human immunodeficiency virus patients: A multicenter retrospective case-control study. World J Gastrointest Endosc 2023; 15:480-490. [PMID: 37397972 PMCID: PMC10308277 DOI: 10.4253/wjge.v15.i6.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Although esophageal candidiasis (EC) may manifest in immunocompetent individuals, there is a lack of consensus in the current literature about predisposing conditions that increase the risk of infection.
AIM To determine the prevalence of EC in patients without human immunodeficiency virus (HIV) and identify risk factors for infection.
METHODS We retrospectively reviewed inpatient and outpatient encounters from 5 regional hospitals within the United States (US) from 2015 to 2020. International Classification of Diseases, Ninth and Tenth Revisions were used to identify patients with endoscopic biopsies of the esophagus and EC. Patients with HIV were excluded. Adults with EC were compared to age, gender, and encounter-matched controls without EC. Patient demographics, symptoms, diagnoses, medications, and laboratory data were obtained from chart extraction. Differences in medians for continuous variables were compared using the Kruskal-Wallis test and categorical variables using chi-square analyses. Multivariable logistic regression was used to identify independent risk factors for EC, after adjusting for potential confounding factors.
RESULTS Of the 1969 patients who had endoscopic biopsies of the esophagus performed from 2015 to 2020, 295 patients had the diagnosis of EC. 177 of 1969 patients (8.99%) had pathology confirming the diagnosis of EC and were included in the study for data collection and further analysis. In comparison to controls, patients with EC had significantly higher rates of gastroesophageal reflux disease (40.10% vs 27.50%; P = 0.006), prior organ transplant (10.70% vs 2%; P < 0.001), immunosuppressive medication (18.10% vs 8.10%; P = 0.002), proton pump inhibitor (48% vs 30%; P < 0.001), corticosteroid (35% vs 17%; P < 0.001), Tylenol (25.40% vs 16.20%; P = 0.019), and aspirin use (39% vs 27.50%; P = 0.013). On multivariable logistic regression analysis, patients with a prior organ transplant had increased odds of EC (OR = 5.81; P = 0.009), as did patients taking a proton pump inhibitor (OR = 1.66; P = 0.03) or corticosteroids (OR = 2.05; P = 0.007). Patients with gastroesophageal reflux disease or medication use, including immunosuppressive medications, Tylenol, and aspirin, did not have a significantly increased odds of EC.
CONCLUSION Prevalence of EC in non-HIV patients was approximately 9% in the US from 2015-2020. Prior organ transplant, proton pump inhibitors, and corticosteroids were identified as independent risk factors for EC.
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Affiliation(s)
- Alexandra V Kimchy
- Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, United States
| | - Akram I Ahmad
- Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC 20007, United States
| | - Lindsey Tully
- Department of Internal Medicine, Georgetown University School of Medicine, Washington, DC 20007, United States
| | - Connor Lester
- Department of Internal Medicine, Georgetown University School of Medicine, Washington, DC 20007, United States
| | - Kavya Sanghavi
- Department of Biostatistics and Biomedical Informatics, MedStar Research Institute, Hyattsville, MD 20781, United States
| | - Joseph J Jennings
- Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC 20007, United States
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Alduraibi RK, Elzaki EM, Alammari A. An unusual presentation of diabetic ketoacidosis associated with ascariasis and fungal esophagitis: A case report. Medicine (Baltimore) 2022; 101:e32015. [PMID: 36451505 PMCID: PMC9704938 DOI: 10.1097/md.0000000000032015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Gastrointestinal symptoms are most commonly observed in patients with diabetic ketoacidosis (DKA), which usually resolves completely with therapy. However, gastrointestinal symptoms may persist after DKA is resolved. PATIENT CONCERNS A 22-year-old female was admitted to hospital for epigastric pain and persistent vomiting. The results of laboratory examination showed fungal esophagitis complicated by DKA. DIAGNOSIS The patient was diagnosed with DKA associated with ascariasis and fungal esophagitis. OUTCOME The patient was discharged after treatment. LESSONS In this case, despite the correction of metabolic acidosis, persistent nausea, vomiting and dysphagia can be a sign of esophagitis in patients with type 1 diabetes. Therefore, physicians should be aware of fungal infections associated with type 1 diabetes.
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Affiliation(s)
- Rabia Khalid Alduraibi
- Department of Endocrine and Diabetes, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
- * Correspondence: Rabia Khalid Alduraibi, Department of Endocrine and Diabetes, King Fahad Specialist Hospital, Box 3499, Buraydah 52385 – 669, Saudi Arabia (e-mail: )
| | - Elzaki Mohamed Elzaki
- Department of Endocrine and Diabetes, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Ammar Alammari
- Department of Gastroenterology, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
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Wang Y, Zhou H, Wang W, Duan N, Luo Z, Chai H, Jiang L, Chen Q, Liu J, Hua H, Yan Z, Fan Y, Xu J, Guan X, Wang H, Lu H, Lun W, Fei W, Zhang T, Zhao J, Jia C, Kong H, Shen X, Liu Q, Wang W, Tang G. Efficacy and safety of miconazole muco-adhesive tablet versus itraconazole in oropharyngeal candidiasis: A randomized, multi-centered, double-blind, phase 3 trial. Med Mycol 2022; 60:myac076. [PMID: 36149321 DOI: 10.1093/mmy/myac076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/16/2022] [Accepted: 09/21/2022] [Indexed: 11/14/2022] Open
Abstract
Oropharyngeal candidiasis (OPC) is an opportunistic infection treated with anti-fungal agents. Herein, we evaluate the efficacy and safety of miconazole buccal tablets (MBT) and itraconazole capsules in the localized treatment of patients with OPC. In this multi-centered, double-blinded, phase III trial (CTR20130414), both males and non-pregnant females (≥18 years) with OPC were randomized (1:1) to MBT plus placebo (experimental group) or itraconazole capsules plus placebo (control group). The primary endpoint was clinical cure at the end-of-treatment period [visit 4 (V4)] while secondary endpoints were clinical remission rates, partial remission rates, mycological cure, clinical relapse, and adverse events (AEs). All endpoints were statistically analyzed in both the full analysis set (FAS) and per-protocol (PP) set. A total of 431 (experimental: 216; control: 215) subjects were included. At V4, in the FAS set, the clinical cure was achieved in 68% and 59% patients in experimental and control groups, respectively with a treatment difference of 9% [95% confidence interval (CI): -1,19; P < .001] demonstrating non-inferiority of MBT over itraconazole. At V4, mycological cure rates were 68.2% and 42.0% in the experimental group and control groups (P < .001), respectively in FAS. The relapse rates were 5.4% and 6.6%, respectively, in the experimental and control groups. A total of 210 patients experienced AEs during treatment with 47.7% in the experimental group and 49.8% in the control group with no deaths. This study demonstrated that once-daily treatment with MBT was non-inferior to itraconazole with higher mycological cure rates and was tolerable with mild AE in patients with OPC.
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Affiliation(s)
- Yufeng Wang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
| | - Haiwen Zhou
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
| | - Wenmei Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu, China
| | - Ning Duan
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu, China
| | - Zhixiao Luo
- Dental Department, Taihe Hospital, Affiliated Hospital of Hubei, University of Medicine, Shiyan 442099, Hubei, China
| | - Hongbo Chai
- Dental Department, Taihe Hospital, Affiliated Hospital of Hubei, University of Medicine, Shiyan 442099, Hubei, China
| | - Lu Jiang
- Department of Oral Medicine, West China School/Hospital Stomatology Sichuan University, Chengdu 610042, Sichuan, China
| | - Qianming Chen
- Department of Oral Medicine, West China School/Hospital Stomatology Sichuan University, Chengdu 610042, Sichuan, China
| | - Jinli Liu
- Department of Oral Medicine, West China School/Hospital Stomatology Sichuan University, Chengdu 610042, Sichuan, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhimin Yan
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Yuan Fan
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Juanyong Xu
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Xiaobing Guan
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Hongjian Wang
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Hongzhou Lu
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Wenhui Lun
- Department of Dermatology and Venereology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Wei Fei
- Department of Stomatology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Jizhi Zhao
- Department of Stomatology, Peking Union Medical College Hospital, Beijing 100730, China
| | - Chunling Jia
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Hui Kong
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Medicine, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Xuemin Shen
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
| | - Qing Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Medicine, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Weizhi Wang
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
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Hentschel F. Chronic fibrosing esophagitis with diffuse esophageal intramural pseudo‐diverticulosis. JGH OPEN 2022; 6:287-291. [PMID: 35601128 PMCID: PMC9120889 DOI: 10.1002/jgh3.12750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/24/2022] [Accepted: 04/23/2022] [Indexed: 12/01/2022]
Abstract
Diffuse esophageal intramural pseudo‐diverticulosis (DEIPD) is a chronic fibrosing inflammation of the esophagus of unknown origin. Its name derives from the characteristic pseudo‐diverticula formed by dilated ducts of submucosal glands. With an assumed prevalence of approximately 5–50/100 000, DEIPD is more frequent than previously estimated. It preferentially affects men between 50 and 70 years of age with a history of alcohol and tobacco abuse. Key symptoms are chronic dysphagia and food impactions. Typical endoscopic findings are multiple small, longitudinally aligned pseudo‐diverticle openings and trachealization of the esophagus. Additionally, the usually gray mucosa may show a fine‐grained pattern of very small red dots that merge into a pink tint, called “faux uni pattern.” Once established, clinical symptoms and endoscopic changes persist throughout life. Although there is no known causal therapy, complications like bolus impactions, candida infections, or reflux can and should be treated.
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Affiliation(s)
- Florian Hentschel
- Department of Gastroenterology and Hepatology Brandenburg Medical School (Theodor Fontane) Brandenburg Germany
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7
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Rodrigues S, Leitão Esteves V, Martins TG. Esophageal Candidiasis in a Non-HIV Patient: A Primary Care Diagnosis. Cureus 2022; 14:e24312. [PMID: 35602778 PMCID: PMC9122014 DOI: 10.7759/cureus.24312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 12/04/2022] Open
Abstract
A 74-year-old man visited his family doctor for dysphagia and was diagnosed with esophageal candidiasis. His risk factors included type 2 diabetes mellitus, long-term intake of budesonide/formoterol inhaler 160/45 µg, and pantoprazole 20 mg. He was treated with fluconazole 200 mg per day for 14 days. Other factors of immunosuppression were excluded, and his chronic medication was adapted by starting him with a proton pump inhibitor withdrawal plan and switching his inhaled device to a formoterol-only device without an inhaled corticosteroid. The patient had complete remission of the symptoms on the seventh day of treatment without relapse to date. The key point is that iatrogenic factors should be considered in the presence of esophageal candidiasis in immunocompetent patients and a therapeutic review is an important tool that should be used in every primary care appointment to refrain from long-term prescriptions without clinical indication and, consequently, to avoid adverse events.
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Ogiso H, Adachi S, Mabuchi M, Horibe Y, Ohno T, Suzuki Y, Yamauchi O, Kojima T, Takada E, Iwama M, Saito K, Iwashita T, Ibuka T, Yasuda I, Shimizu M. Risk factors for the development of esophageal candidiasis among patients in community hospital. Sci Rep 2021; 11:20663. [PMID: 34667198 PMCID: PMC8526817 DOI: 10.1038/s41598-021-00132-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/17/2021] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to clarify risk factors for esophageal candidiasis (EC) in immunocompetent patients in a community hospital. 7736 patients who underwent esophagogastroduodenoscopy at our hospital from April 2012 to July 2018 were enrolled. The relationships between EC and the following factors: age, gender, body mass index, lifestyle, lifestyle-related diseases, medication, and endoscopic findings were analyzed. EC was observed in 184 of 7736 cases (2.4% morbidity rate). Multivariate analysis revealed that significant risk factors for the development of EC were: diabetes mellitus {odds ratio (OR): 1.52}, proton pump inhibitor (PPI) use (OR: 1.69), atrophic gastritis (AG) (OR: 1.60), advanced gastric cancer (OR: 4.66), and gastrectomy (OR: 2.32). When severe EC (Kodsi grade ≥ II) was compared to mild EC (grade I), the most significant risk factors were advanced gastric cancer (OR: 17.6) and gastrectomy (OR: 23.4). When considering the risk of AG and PPI use with EC development, the risk increased as follows: AG (OR: 1.59), PPI use (OR: 2.25), and both (OR: 3.13). PPI use, AG, advanced gastric cancer and post-gastrectomy are critical risk factors for the development of EC. We suggest close monitoring for EC development when PPIs are administered to patients with these factors.
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Affiliation(s)
- Hideyuki Ogiso
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Seiji Adachi
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan.
| | - Masatoshi Mabuchi
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Yohei Horibe
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Tomohiko Ohno
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Yusuke Suzuki
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Osamu Yamauchi
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Takao Kojima
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Eri Takada
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Midori Iwama
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Koshiro Saito
- Department of Gastroenterology/Internal Medicine, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, 501-2105, Japan
| | - Takuji Iwashita
- Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takashi Ibuka
- Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Ichiro Yasuda
- Third Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Masahito Shimizu
- Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
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Ghoddoosi M, Jazi K, Hajrezaei Z, Habibi MA, Ahmadpour S, Pezeshki Modares M. UPPER GASTROINTESTINAL BLEEDING DUE TO CONCOMITANT ESOPHAGEAL VARICES AND HERPES SIMPLEX VIRUS ESOPHAGITIS IN A 70-YEAR-OLD PATIENT. Gastroenterol Nurs 2021; 44:357-360. [PMID: 34269710 DOI: 10.1097/sga.0000000000000598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/19/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Mahdieh Ghoddoosi
- Mahdieh Ghoddoosi, PhD, MD, is Assistant Professor of Pathology, Department of Pathology, Shahid Beheshti Medical Centre, Qom University of Medical Sciences, Qom, Iran
- Kimia Jazi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Zahra Hajrezaei, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Mohammad Amin Habibi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Mahdi Pezeshki Modares, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Kimia Jazi
- Mahdieh Ghoddoosi, PhD, MD, is Assistant Professor of Pathology, Department of Pathology, Shahid Beheshti Medical Centre, Qom University of Medical Sciences, Qom, Iran
- Kimia Jazi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Zahra Hajrezaei, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Mohammad Amin Habibi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Mahdi Pezeshki Modares, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Hajrezaei
- Mahdieh Ghoddoosi, PhD, MD, is Assistant Professor of Pathology, Department of Pathology, Shahid Beheshti Medical Centre, Qom University of Medical Sciences, Qom, Iran
- Kimia Jazi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Zahra Hajrezaei, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Mohammad Amin Habibi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Mahdi Pezeshki Modares, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Amin Habibi
- Mahdieh Ghoddoosi, PhD, MD, is Assistant Professor of Pathology, Department of Pathology, Shahid Beheshti Medical Centre, Qom University of Medical Sciences, Qom, Iran
- Kimia Jazi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Zahra Hajrezaei, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Mohammad Amin Habibi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Mahdi Pezeshki Modares, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Sajjad Ahmadpour
- Mahdieh Ghoddoosi, PhD, MD, is Assistant Professor of Pathology, Department of Pathology, Shahid Beheshti Medical Centre, Qom University of Medical Sciences, Qom, Iran
- Kimia Jazi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Zahra Hajrezaei, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Mohammad Amin Habibi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Mahdi Pezeshki Modares, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mahdi Pezeshki Modares
- Mahdieh Ghoddoosi, PhD, MD, is Assistant Professor of Pathology, Department of Pathology, Shahid Beheshti Medical Centre, Qom University of Medical Sciences, Qom, Iran
- Kimia Jazi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Zahra Hajrezaei, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Mohammad Amin Habibi, MD, is Medical Doctor, Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Mahdi Pezeshki Modares, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
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Panarelli NC. Infectious diseases of the upper gastrointestinal tract. Histopathology 2020; 78:70-87. [PMID: 33382485 DOI: 10.1111/his.14243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/10/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022]
Abstract
A broad spectrum of pathogens produce gastrointestinal disease. The ongoing spread of human immunodeficiency virus/acquired immune deficiency syndrome, the increased use of immunosuppressive therapy and the persistence of overcrowding and suboptimal sanitation in underdeveloped areas facilitate both disease transmission from environmental and foodborne sources and person-to-person transmission. Clinicians increasingly rely on endoscopic biopsy sample interpretation to diagnose gastrointestinal infections. Thus, pathologists must be aware of diagnostic features of a variety of microbial pathogens. Detection with molecular techniques also allows for correlation between infectious agents and their histopathological features, which has expanded our knowledge of the inflammatory changes produced by infectious agents. This review covers infectious disorders of the upper gastrointestinal tract encountered in surgical pathology. Clinical, endoscopic and pathological features are presented. The review emphasises morphological features of viruses, bacteria, fungi and parasites that may be found in tissue samples, and the inflammatory patterns that they produce. Differential diagnoses and useful ancillary techniques are discussed.
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11
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Diagnosis and Treatment of Esophageal Candidiasis: Current Updates. Can J Gastroenterol Hepatol 2019; 2019:3585136. [PMID: 31772927 PMCID: PMC6854261 DOI: 10.1155/2019/3585136] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/27/2019] [Accepted: 09/23/2019] [Indexed: 11/17/2022] Open
Abstract
Esophageal candidiasis (EC) is the most common type of infectious esophagitis. In the gastrointestinal tract, the esophagus is the second most susceptible to candida infection, only after the oropharynx. Immunocompromised patients are most at risk, including patients with HIV/AIDS, leukemia, diabetics, and those who are receiving corticosteroids, radiation, and chemotherapy. Another group includes those who used antibiotics frequently and those who have esophageal motility disorder (cardiac achalasia and scleroderma). Patients complained of pain on swallowing, difficulty swallowing, and pain behind the sternum. On physical examination, there is a plaque that often occurs together with oral thrush. Endoscopic examination is the best approach to diagnose this disease by directly observing the white mucosal plaque-like lesions and exudates adherent to the mucosa. These adherent lesions cannot be washed off with water from irrigation. This disease is confirmed histologically by taking the biopsy or brushings of yeast and pseudohyphae invading mucosal cells. The treatment is by systemic antifungal drugs given orally in a defined course. It is important to differentiate esophageal candidiasis from other forms of infectious esophagitis such as cytomegalovirus, herpes simplex virus, gastroesophageal reflux disease, medication-induced esophagitis, radiation-induced esophageal injury, and inflammatory conditions such as eosinophilic esophagitis. Except for a few complications such as necrotizing esophageal candidiasis, fistula, and sepsis, the prognosis of esophageal candidiasis has been good.
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Abstract
Because of its high incidence gastroesophageal reflux disease (GERD) is at the forefront of medical attention. On the other hand, vigilance for rare inflammatory diseases of the esophagus, such as herpes esophagitis, radiation-induced esophagitis, eosinophilic esophagitis, pseudodiverticulosis and Crohn's disease is low. Moreover, these entities are rarely distinguishable from GERD by clinical features alone. For all atypical and treatment refractory supposedly reflux diseases, the diagnosis should therefore be questioned and re-evaluated by endoscopy. When the macroscopic findings of esophagoscopy are ambiguous biopsies can be performed and histological examination then often leads to a definitive diagnosis. This is particularly important because the required treatment of rare forms of esophagitis often significantly differs from that of GERD.
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Affiliation(s)
- Florian Hentschel
- Zentrum für Innere Medizin II, Hochschulklinikum Brandenburg, Medizinische Hochschule Brandenburg, Hochstr. 29, 14770, Brandenburg an der Havel, Deutschland.
| | - Stefan Lüth
- Zentrum für Innere Medizin II, Hochschulklinikum Brandenburg, Medizinische Hochschule Brandenburg, Hochstr. 29, 14770, Brandenburg an der Havel, Deutschland
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13
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Liang M, Liwen Z, Juan D, Yun Z, Yanbo D, Jianping C. A rare case report of fungal esophagitis combined with giant gastric ulcer in an immunocompetent patient. Medicine (Baltimore) 2019; 98:e14158. [PMID: 30653156 PMCID: PMC6370008 DOI: 10.1097/md.0000000000014158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Fungal infection of gastrointestinal (GI) tract is usually seen in immunocompromised patients, but can rarely occur in immunocompetent people in whom no permissive factor is present. PATIENT CONCERNS We describe a 68-year-old male immunocompetent patient presenting with simultaneous fungal esophagitis and giant gastric ulcer. DIAGNOSES Repeated endoscopic biopsies were taken from the giant gastric ulcer edge and base and histology demonstrated granulation tissue and pseudohyphal fungal forms. INTERVENTIONS The patient was treated with fluconazole and omeprazole for 8 weeks. OUTCOMES After antifungal treatment with fluconazole, the patient's clinical symptoms gradually disappeared with the healing of gastric ulcer, which never recurred in this patient until 3 months after follow-up. LESSONS Nonhealing gastroesophageal ulcers highlights the importance of repeated endoscopies and biopsies.
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Affiliation(s)
- Ma Liang
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Zhang Liwen
- Department of Pediatrics, the Second People's Hospital of Changzhou, Affiliate Hospital of NanJing medical University, Changzhou, Jiangsu, China
| | - Dai Juan
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Zhuang Yun
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Ding Yanbo
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Chen Jianping
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
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