IDDF2019-ABS-0181 Endoscopic and microbiological characteristics of patients with fungal esophagitis

Abstract

Background Fungal esophagitis is an uncommon condition which is usually found in patients with an impaired immune system. Patients with normal immune system could also develop fungal esophagitis. In Vietnam, there have not been many researches on fungal esophagitis with details of endoscopic findings and culture results. This study aimed to evaluate the severity of fungal esophagitis by Kodsi classification and identify types of fungi. Methods An observational study was conducted at the Institute of Gastroenterology and Hepatology from November 2017 to October 2018. Biopsy specimens of patients with suitable endoscopic findings and positive direct microscopic detection were sent to the National Hospital of Dermatology and Venereology for fungal culture and identification. The study collected endoscopic findings, the severity of fungal esophagitis assessed by Kodsi classification and fungal culture results. Results The prevalence of fungal esophagitis in the total number of upper endoscopies during the study time was 1.4%. 165 patients (86 males and 76 females) were included in the study with the mean age of 51.8 ± 11.9 (50–59 years old group was predominant). 44.2% of patients had other esophageal lesions. The proportions of patients with fungal esophagitis grade I, II and III according to Kodsi classification were 47.3%, 47.3%, and 5.4%, respectively. 155 patients had positive fungal culture results, among them: 143 (92.3%) were Candida albicans, 11 (7.1%) were other species of Candida, and 1 was Fusarium oxysporum (table 1). Conclusions Fungal infection coexisted with other esophageal lesions. Most patients had mild fungal esophagitis. The proportion of positive fungal culture was high with the predominance of Candida albicans.