Samonis G, Skordilis P, Maraki S, Datseris G, Toloudis P, Chatzinikolaou I, Georgoulias V, Bodey G P
Division of Medicine, University of Crete, Heraklion, Greece.
Clin Infect Dis. 1998 Aug;27(2):283-6. doi: 10.1086/514653.
The present study was designed to determine the frequency of candidal esophagitis in cancer patients with oral thrush. Patients with clinically and microbiologically diagnosed oral candidiasis were evaluated by endoscopy for concurrent esophageal candidiasis. Esophageal involvement was documented by mucosal lesions, microbiological findings of candidal infection in smears of brushing material, positive cultures of brushing material, and histological evidence of mucosal invasion by the yeast. For 21 of the 22 patients studied, there were endoscopic and microbiological findings of candidal esophagitis. Cultures of the brushing material from all 22 patients were positive, while histological evidence was found for 14 patients. Only 10 of the patients had mild esophageal symptoms. It is concluded that oral thrush represents a reliable marker for esophageal candidiasis in patients with cancer. Routine endoscopy is not necessary to confirm the diagnosis; this procedure should be reserved for patients with persistent thrush and symptoms despite antifungal therapy.
本研究旨在确定患有口腔念珠菌病的癌症患者中念珠菌性食管炎的发生率。对临床和微生物学诊断为口腔念珠菌病的患者进行内镜检查，以评估是否并发食管念珠菌病。食管受累通过黏膜病变、刷取物涂片念珠菌感染的微生物学发现、刷取物培养阳性以及酵母对黏膜侵袭的组织学证据来记录。在研究的22例患者中，21例有念珠菌性食管炎的内镜和微生物学发现。所有22例患者的刷取物培养均为阳性，14例有组织学证据。只有10例患者有轻度食管症状。结论是，口腔念珠菌病是癌症患者食管念珠菌病的可靠标志物。确诊无需常规内镜检查；该检查应仅用于抗真菌治疗后仍有持续性鹅口疮和症状的患者。
