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<Emphasis Type="Italic">Candida</Emphasis> esophagitis complicated by an esophago-airway fistula: Report of a case
Authors:Ryu Kanzaki  Masahiko Yano  Ko Takachi  Shingo Ishiguro  Masaaki Motoori  Kentaro Kishi  Isao Miyashiro  Osamu Ishikawa  Shingi Imaoka
Institution:(1) Department of Intensive Care Medicine, Medical School, University of Athens, Athens, Greece;(2) Intensive Care Unit, “G. Gennimatas” General Hospital, Athens, Greece;(3) Department of Medicine, University of Crete School of Medicine, Heraklion, Crete, Greece;(4) Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece;(5) Department of Medicine, Tufts University School of Medicine, Boston, MA, USA;
Abstract:Candida esophagitis rarely involves life-threatening complications, such as necrosis, perforation, or fistula formation between the esophagus and the airway. We herein report a case of Candida esophagitis complicated by esophagobronchial and esophagopulmonary fistulas. The patient in our study was a 70-year-old man with a 3-month history of dysphagia. Based on endoscopy and histological findings, he was diagnosed with a coinfection of Candida spp. and herpes simplex virus. Antifungal and antiviral therapy was administered without success. The esophagopulmonary fistula formation and a lung abscess were identified 7 months later. The patient was deemed intolerable to an esophagectomy due to his poor general condition, thus necessitating a two-stage operation. A cervical esophagostomy and a tube drainage of the thoracic esophagus were followed by an esophageal bypass using the pedicled jejunum via an antethoracic route. Although the lung abscess resolved, the inflammation of the esophagus persisted. A fistula between the esophagus and the left main bronchus eventually formed postoperatively and the patient died due to respiratory failure.
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