nystatin-a1 and Esophagitis

Dysphagia following cardiac surgery is a frequently encountered problem, being most commonly due to the sternotomy incision and/or prolonged intubation. Oesophageal candidiasis is an increasing problem that is usually associated with immunosuppression or immunodeficiency. We report a 59 years age, immunocompetent lady whom had developed dysphagia and odynophagia following open cardiac surgery and long term course of antibiotics. Diagnosis of Candida oesophagitis was established after radiological, endoscopic and microbiological evidence, and successful treatment with combined topical and systemic antifungal therapy was achieved. Possibility of immunodeficiency was excluded. We believe that this lady developed oesophageal candidiasis due to a long-term course of broad spectrum antibiotics. We discuss the various diagnostic modalities and treatment options.

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Candidiasis, Oral; Deglutition Disorders; Dilatation; Drug Therapy, Combination; Esophagitis; Female; Humans; Immunocompetence; Middle Aged; Nystatin; Thoracic Surgery; Treatment Outcome

The oral cavity and the oesophagus are the main sites of involvement in orointestinal candidosis. The clinical pictures of these manifestations are characterized. Involvement of the stomach as well as the small and large intestine is an exceedingly rare but possible manifestation. There are obviously no repeatedly occurring characteristical symptoms, neither have controlled studies confirmed such characteristics. Recently a discussion has arised-undoubtedly to a large extent influenced by public media-to explain a variety of in particular gastrointestinal symptoms as a consequence of an apparent "mycotic infection of the orointestinal tract" as "a new mass disease". These reports lack any scientific basis supported by experimental or clinical studies. There are similarities to the "candidiasis hypersensitivity syndrome" or "the yeast connection", the existence of which has been critically denied by experts. Corresponding references are given. The author realizes the necessity to oppose this public debate on a critical scientific basis and to answer open questions by controlled studies.

Topics: Antifungal Agents; Candidiasis; Candidiasis, Oral; Esophagitis; Humans; Intestinal Diseases; Nystatin; Stomach Diseases; Syndrome

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Esophagitis; Humans; Nystatin

The effectiveness of treatment of candidiasis of the esophagus by different methods and preparations (nystatin, amphotericin B, donor leukocytic mass) was compared in 34 patients. Local application of amphotericin B and donor leukocytic mass was found the most effective in the combined treatment of candidiasis of the esophagus.

Topics: Adult; Amphotericin B; Blood Transfusion; Candidiasis; Clinical Trials as Topic; Esophagitis; Female; Humans; Leukocyte Transfusion; Male; Middle Aged; Nystatin

Of 224 consecutive renal transplant patients in a prospective, randomized immunosuppressive trial, candida esophagitis developed in 5 despite nystatin prophylaxis. No differences were noted between cyclosporine and antilymphocyte globulin-azathioprine immunosuppressive treatment. All patients were diabetic, and four were recipients of cadaver kidneys. Candida esophagitis occurred within 6 months after transplantation, and only one patient had recurrence. All patients responded to treatment consisting of 2 to 6 days of intravenous amphotericin B (0.2 to 2 mg/kg total dose). The prevalence of candida esophagitis was not related to rejection episodes. Three of five patients eventually died, one 2 weeks after resolution of candida esophagitis from a hypoglycemic episode, one from acute exacerbation of pulmonary failure and relapsing pancreatitis in association with candida esophagitis and therapy-resistant candidemia, and one 17 months after candida esophagitis from pulmonary edema. Our findings show that candida esophagitis by itself is an easily managed complication, but is also a sign of potentially increased morbidity in these patients.

Topics: Adult; Amphotericin B; Antilymphocyte Serum; Azathioprine; Candidiasis; Clinical Trials as Topic; Cyclosporins; Esophagitis; Female; Humans; Kidney Transplantation; Male; Minnesota; Nystatin; Prospective Studies; Random Allocation

An 85-year-old man with myasthenia gravis was successfully treated with methotrexate (10 mg/week), pyridostigmine and prednisolone (0-30 mg/day) for over 10 years. Then, he developed dysphagia and lost weight. Gastroscopy revealed Candida esophagitis. The patient received nystatin for 2 weeks. Methotrexate was stopped, and immunosuppressive therapy was continued with prednisolone alone. The patient has now remained in good condition for over 1 year. Although dysphagia is a typical symptom of myasthenia gravis, swallowing disturbances should not be attributed hastily to this disease, since they may also be a complication of therapy.

Topics: Aged; Antifungal Agents; Candidiasis; Deglutition Disorders; Diagnosis, Differential; Drug Therapy, Combination; Esophagitis; Gastroscopy; Humans; Immunosuppressive Agents; Male; Methotrexate; Myasthenia Gravis; Nystatin; Prednisolone; Pyridostigmine Bromide

Topics: AIDS-Related Opportunistic Infections; Ambulatory Care; Amphotericin B; Antifungal Agents; Candidiasis, Oral; Esophagitis; Fluconazole; Guidelines as Topic; Humans; Itraconazole; Ketoconazole; Medical Audit; Nystatin; Retrospective Studies

The authors report a case of Candida esophagitis developed like a malignant neoplasm. They explain the severe lesions according to the last physiopathological findings and emphasize the role of roentgenographic and endoscopic (biopsies and brushing) examinations in the differential diagnosis.

Topics: Aged; Candidiasis; Diagnosis, Differential; Esophageal Neoplasms; Esophagitis; Humans; Male; Nystatin

Topics: Amphotericin B; Candidiasis, Cutaneous; Candidiasis, Oral; Child; Esophagitis; Female; Humans; Ketoconazole; Leukemia, Lymphoid; Male; Nystatin; Thrombocytopenia

A 14-day old infant with stomatitis due to Candida albicans presented with frequent emesis and was found to have esophagitis by barium esophagram. She responded promptly to oral Mycostatin suspension: her emesis subsided and the stomatitis resolved. Repeat esophagram on the seventh day of therapy showed complete resolution of the esophageal mucosal abnormalities. Although Candida stomatitis is common in infants, the incidence and appropriate therapy of Candida esophagitis as a complication in otherwise normal infants are unknown. This patient responded well to frequent therapy with an oral, nonabsorbable antifungal agent.

Topics: Candidiasis; Esophagitis; Female; Humans; Infant, Newborn; Nystatin; Stomatitis

A prospective study of candida esophagitis was undertaken to determine the spectrum of this disease in a general hospital. During 1 year, in 370 consecutive endoscopies, 27 patients with Candida esophagitis were detected. The diagnosis was established by finding white plaques on endoscopy, yeast organisms on microscopic examination of a direct smear from the plaques, and a serum agglutinin titer of at least 1:160. Of these 27 patients, 14 had esophageal symptoms. Twelve patients were reendoscoped after nystatin or nystatin and flucytosine therapy. Nine patients showed absence of lesions, a negative smear, and disappearance of symptoms. Control patients had no plaques on endoscopy, no yeast organisms on microscopical examination of esophageal brushings, and a positive titer in 4 to 17% of cases. A minimal agglutinin titer of 1:160 was found in 4 to 12% of two additional groups on controls. Absence of titer precluded a diagnosis of Candida esophagitis.

Topics: Adolescent; Adult; Aged; Candidiasis; Drug Therapy, Combination; Esophagitis; Esophagoscopy; Female; Flucytosine; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Nystatin; Prospective Studies

Topics: Adrenal Cortex Hormones; Adult; Candidiasis; Esophagitis; Hodgkin Disease; Humans; Male; Nystatin; Radiography

Topics: Candidiasis; Esophagitis; Humans; Nystatin

Topics: Anti-Bacterial Agents; Antineoplastic Agents; Candidiasis; Cobalt Isotopes; Esophageal Diseases; Esophagitis; Esophagoscopy; Glucocorticoids; Humans; Lip Neoplasms; Male; Middle Aged; Nystatin; Pharyngeal Neoplasms; Radiotherapy; Tonsillar Neoplasms

Topics: Adult; Barium; Colitis, Ulcerative; Esophagitis; Esophagoscopy; Humans; Male; Nystatin; Prednisolone; Sigmoidoscopy; Ulcer

Topics: Candida; Candidiasis; Deglutition Disorders; Esophageal Stenosis; Esophagitis; Humans; Male; Middle Aged; Nystatin; Radiography

Topics: Anti-Bacterial Agents; Candidiasis; Candidiasis, Oral; Deglutition Disorders; Diagnosis; Esophagitis; Humans; Nystatin; Pneumonia; Prednisolone; Radiography; Sulfonamides; Tetracycline

Topics: Diabetes Mellitus; Esophagitis; Esophagoscopy; Humans; Nystatin; Yeasts

Topics: Candidiasis; Child; Chronic Disease; Diagnosis, Differential; Esophagitis; Fluoroscopy; Geriatrics; Humans; Nystatin; Respiratory Tract Diseases

Topics: Candida albicans; Candidiasis; Candidiasis, Oral; Deglutition Disorders; Esophagitis; Esophagoscopy; Humans; Lung Neoplasms; Nystatin; Oxytetracycline; Penicillins; Speech Disorders; Vocal Cord Paralysis