OROPHARYNGEAL CANDIDIASIS AS A MARKER FOR ESOPHAGEAL CANDIDIASIS IN PATIENTS WITH CANCER

The present study was designed to determine the frequency of candidal esophagitis in cancer patients with oral thrush. Patients with clinica lly and microbiologically diagnosed oral candidiasis were evaluated by endoscopy for concurrent esophageal candidiasis. Esophageal involveme nt was documented by mucosal lesions, microbiological findings of cand idal infection in smears of brushing material, positive cultures of br ushing material, and histological evidence of mucosal invasion by the yeast. For 21 of the 22 patients studied, there were endoscopic and mi crobiological findings of candidal esophagitis. Cultures of the brushi ng material from all 22 patients were positive, while histological evi dence was found for 14 patients. Only 10 of the patients had mild esop hageal symptoms. It is concluded that oral thrush represents a reliabl e marker for esophageal candidiasis in patients with cancer. Routine e ndoscopy is not necessary to confirm the diagnosis; this procedure sho uld be reserved for patients with persistent thrush and symptoms despi te antifungal therapy.