G Badarinarayanan1, R Gowrisankar, K Muthulakshmi. 1. Department of Gastroenterology and Hepatology, AVB Clinic, Perumal East Car Street, Tirunelveli-627 001, India. badari@md3.vsnl.net.in
Abstract
OBJECTIVES: Prevalence of Esophageal Candidiasis in non-immune compromised patients in a semi-urban town, was investigated. Further, various investigation procedures to detect the candidal pathogen were compared. METHODS: A total of 933 patients with odynophagia and dysphagia were included in this study. Upper GI endoscopy was performed in all these patients and biopsy specimens were taken from the site of lesions. Oral swabs were also taken. Both these specimens were analyzed for the presence of fungal pathogen through, direct microscopic examination and culture method. RESULTS: Among the diagnostic techniques, culture of biopsy in Sabouraud's media was found to be the most reliable method. Of the 933 trialists, 61 were found to have lesions of varied degree of severity. Among these, 56 were positive for fungal pathogen, which was confirmed by germ tube test, cultural characteristics, auxanogram, etc., Candida albicans (87.5%) was the most predominant pathogen followed by C. tropicalis (8.9%). Men in the age group of 40 years and above were observed to have higher frequency of candidal infections compared to other groups of trialists. CONCLUSION: This investigation strongly suggests the possibilities of candidal infections in patients even in the absence of predisposing factors such as HIV infection or immune compromised conditions. Hence, patients with symptoms of odynophagia and dysphagia shall be considered for possible esophageal candidiasis.
OBJECTIVES: Prevalence of Esophageal Candidiasis in non-immune compromised patients in a semi-urban town, was investigated. Further, various investigation procedures to detect the candidal pathogen were compared. METHODS: A total of 933 patients with odynophagia and dysphagia were included in this study. Upper GI endoscopy was performed in all these patients and biopsy specimens were taken from the site of lesions. Oral swabs were also taken. Both these specimens were analyzed for the presence of fungal pathogen through, direct microscopic examination and culture method. RESULTS: Among the diagnostic techniques, culture of biopsy in Sabouraud's media was found to be the most reliable method. Of the 933 trialists, 61 were found to have lesions of varied degree of severity. Among these, 56 were positive for fungal pathogen, which was confirmed by germ tube test, cultural characteristics, auxanogram, etc., Candida albicans (87.5%) was the most predominant pathogen followed by C. tropicalis (8.9%). Men in the age group of 40 years and above were observed to have higher frequency of candidal infections compared to other groups of trialists. CONCLUSION: This investigation strongly suggests the possibilities of candidal infections in patients even in the absence of predisposing factors such as HIV infection or immune compromised conditions. Hence, patients with symptoms of odynophagia and dysphagia shall be considered for possible esophageal candidiasis.
Authors: Vishwanath Sathyanarayanan; Abdul Razak; M Mukhyprana Prabhu; Kavitha Saravu; Pai C Ganesh; Anuradha K Rao Journal: Asian Pac J Trop Biomed Date: 2011-06