Is endoscopic diagnosis of Candida albicans esophagitis reliable? Correlations with pathology and mycology

Aim of study - To assess the reliability of endoscopic diagnosis of Candida albicans esophagitis. Patients and methods - A case - control prospective study was carried out f rom November 1997 to July 1998 at the Campus Teaching Hospital of Lome, in patients with esophagitis macroscopically suggestive of Candida albicans or igin at upper digestive endoscopy. Fifteen subjects with normal endoscopy s erved as controls. Esophageal biopsies for mycologic and pathological exami nation were performed, as well as HIV serology. Results - During the study period, 26 of the 850 performed in our Unit reve aled an esophagitis suggestive albicans origin, Mycology confirmed the pres ence of filamentous form of Candida albicans in 23 patients and pathology s howed non-specific lesions of esophagitis, 20 with intramucous hyphae. HIV was positive in 19/23 patients (82.6%) and in 1/15 (6.6%). Sensitivity and specifcity of upper GI endoscopy for the diagnosis of Candida albicans were 100 and 83.3% respectively; positive and negative predictive values were 8 8.5 and 100%, respectively. Conclusion - Upper digestive endoscopy is a reliable method For the diagnos is of Candida albicans esophagitis. However, mycological confirmation is wa rranted.