Redah D, Konutse A Y, Agbo K, Dogbey E H, Napo-Koura G, Tchangai-Kao S T, Prince-David M, Amedegnato D M, Agbetra A
Service d'Hépato-Gastroentérologie, CHU, Lomé, Togo.
Gastroenterol Clin Biol. 2001 Feb;25(2):161-3.
To assess the reliability of endoscopic diagnosis of Candida albicans esophagitis.
A case - control prospective study was carried out from November 1997 to July 1998 at the Campus Teaching Hospital of Lome, in patients with esophagitis macroscopically suggestive of Candida albicans origin at upper digestive endoscopy. Fifteen subjects with normal endoscopy served as controls. Esophageal biopsies for mycologic and pathological examination were performed, as well as HIV serology.
During the study period, 26 of the 850 endoscopies performed in our Unit revealed an esophagitis suggestive of Candida albicans origin. Mycology confirmed the presence of filamentous form of Candida albicans in 23 patients and pathology showed non-specific lesions of esophagitis, 20 with intramucous hyphae. HIV serology was positive in 19/23 patients (82.6%) and in 1/15 controls (6.6%). Sensitivity and specificity of upper GI endoscopy for the diagnosis of Candida albicans were 100 and 83.3% respectively; positive and negative predictive values were 88.5 and 100%, respectively.
Upper digestive endoscopy is a reliable method for the diagnosis of Candida albicans esophagitis. However, mycological confirmation is warranted.
评估内镜诊断白色念珠菌食管炎的可靠性。
1997年11月至1998年7月在洛美校园教学医院开展了一项病例对照前瞻性研究，研究对象为上消化道内镜检查时宏观表现提示白色念珠菌源性食管炎的患者。15名内镜检查正常的受试者作为对照。进行了食管活检以进行真菌学和病理学检查，以及HIV血清学检测。
在研究期间，我们科室进行的850例内镜检查中有26例显示为提示白色念珠菌源性的食管炎。真菌学检查证实23例患者存在白色念珠菌丝状形态，病理学显示为食管炎的非特异性病变，20例有黏膜内菌丝。19/23例患者（82.6%）和1/15例对照（6.6%）的HIV血清学检测呈阳性。上消化道内镜诊断白色念珠菌的敏感性和特异性分别为100%和83.3%；阳性预测值和阴性预测值分别为88.5%和100%。
上消化道内镜检查是诊断白色念珠菌食管炎的可靠方法。然而，真菌学确认仍然必要。
