Wednesday, 23 November 2016

Esophageal Candidiasis in an Immunocompetent Girl with Chronic Anaemia

Infection is an uncommon cause of esophagitis among the paediatric population. The main risk factor is immunodeficiency. In children immunocompromised due HIV infection, certain endocrine diseases, and corticosteroid or immunosuppressive therapy, Candida albicans is the most common etiologic agent. The prevalence of Candida esophagitis has increased because of an improvement in survival and management of immunological diseases. 

Esophageal Candidiasis
Even though it is not frequent in immunocompetent children, there have been reported cases related with risk factors (Chocarro,2000) such as antibiotic intake (which allow bacterial overgrowth and fungal colonization), proton pump inhibitors (which produce hypochlorhydria allowing oral bacteria to colonize gastric mucosa, and to increase the risk of infectious esophagitis), esophageal obstruction (aperistalsis and stasis helps the fungal overgrowth) and systemic or inhalated corticotherapy (that suppresses lymphocyte and granulocyte function) (Simon, 1997). Candida esophagitis has also been reported in healthy patients, with no evidence of causal mechanism (Alemán, 1996).