Recurrent esophageal candidosis (rec) in HIV-negative patients in S.Pb, Russia

Melekhina, J.E.

Author address: 

Medical Academy of Postgraduate, SQINT-PETERSBURG, Russian Federation

Abstract: 

Background:The problem of a re1089;current candid1086;sis of esophagus (REC) in HIV- negative patients is not studied enough. REC reduces quality of life of patients, in1089;reases treatment expenses and causes such complications, as a stricture and an esophageal bleeding. Aim of the study: to study an etiology, risk factors, clinical characteristics and efficiency of secondary antifungal prophylaxis at patients with REC. Methods: 61 patients with REC in the age from 30 up to 70 (median - 54), 50 women and 11 men, have been surveyed during 2004-2007. Endoscopic examination with a biopsy of a mucosa of an esophagus and micological study at biopsy material with determination of the species of pathogens have been carried out in all the patients. Identification of the Candida spp. was carried out with use of Auxacolor and API 20C AUX tests. Determination of susceptibility of pathogens to fluconasole was carried out with the disco-diffusion CLSI M44-A method. REC was diagnosed on the basis of a repeated episode of an esophagus candidosis during 6 months after the proved recovery of a primary episode. Results: All patients the pathogen was C. 1072;lbicans, sensitive in vitro to fluconasole. Typical risk factors of a candidosis (a diabetes mellitis, therapy with glucocorticoids) have been detected at 80% of patients. The treatment of the first episode of a REC was fluconasole 150 mg/d during 14 days. All the patients had the recurrence of disease in 6 months. The clinical picture of a REC was usually characterized by a dysphagia and a retrosternal discomfort. During endoscopic examination hyperemia and contact sensitivity of a mucosa of esophagus as well as occurrence of fibrinous focal incrustations of white color were discovered during endoscopic examination. Recurrence was treated with fluconasole 150 mg/d during 14 days/. Secondary antifungal prophylaxis was fluconasole 150 mg once a week during 6 months. At 90% the re1089;urrence of disease was not observed, in 10% patients REC was detected again. Conclusions: The re1089;current candidosis of an esophagus is caused by C. 1072;lbicans, sensitive to fluconasole. Secondary antifungal prophylaxis with fluconasole 150 mg/wk for 6 months is effective in 90% of patients.
2007

abstract No: 

P045

Full conference title: 

3rd Trends in Medical Mycology
    • TIMM 3rd (2011)