Spontaneous candida mediastinitis diagnosed by endoscopic ultrasound-guided, fine-needle aspiration

Candida mediastinitis is a ran clinical entity associated with high mortali ty and morbidity. It is emerging as an important clinical entity, probably due to increased recognition of candida as a significant pathogen in medias tinitis. Candida mediastinitis is usually associated with cardiothoracic su rgery, esophageal perforation, and head and neck infections. Optimal therap y for candida mediastinitis remains undefined. Aggressive, combined surgica l debridement and antifungal therapy appears to be the most effective of av ailable therapies. We report a case of spontaneous candida mediastinitis di agnosed by endoscopic ultrasound-guided, fine-needle aspiration and success fully treated with oral antifungal therapy alone. (C) 2000 by Am. Cell, of Gastroenterology.