[Patterns of Candida esophagitis in cancer and AIDS patients: histopathological study of 23 patients] NLM AIDSLINE Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

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[Patterns of Candida esophagitis in cancer and AIDS patients: histopathological study of 23 patients]

Mycoses. 1997;40 Suppl 1:81-5. Unique Identifier : AIDSLINE MED/98037235
Gornig M; Emmert-Buck M; Walsh TJ; Klinik fur Hautkrankheiten, Friedrich-Schiller-Universitat, Jena.

Abstract: Candida oesophagitis is a common concomitant disease in neutropenic cancer patients after chemotherapie as well as in HIV-patients. In order to characterize the features of oesophagitis in each population, we reviewed the medical history and pathology records of 23 patients (18 cancer-patients, 5 HIV-patients) with culture and autopsy-proven Candida oesophagitis. Histopathological patterns of morphology, invasion, angioinvasion and inflammation were evaluated. Virtually all patients, 17/18 cancer- and 5/5 HIV-patients, had a history of previous mucosal candidosis or candidemia. There was a significant difference histopathologically in depth of invasion of the Candida-organisms between cancer and HIV-patients. Only in HIV-patients organisms were observed within the muscularis propria and the adventitia (2/5 vs 0/18; p = 0.04). The frequency of angioinvasion (12/18 vs 3/5) was similar in both groups. Neutropenia (< 500/microliter) was present in 12 (68%) of 18 cancer patients vs 0/5 HIV-patients (p = 0.01). Correspondingly there was a significant higher PMN/MN ratio in the oesophageal inflammatory infiltrate in HIV-patients, reflecting chemotherapy-induced neutropenia in cancer patients (p = 0.02). Oesophageal candidosis in HIV-patients may be highly invasive despite the presence of neutrophils. These findings suggest an impaired inflammatory response of HIV-patients to invasive candidosis, leading to impaired mucosal host defence.
Keywords: *AIDS-Related Opportunistic Infections/PATHOLOGY *Candidiasis/PATHOLOGY *Esophagitis/MICROBIOLOGY *Esophagitis/PATHOLOGY *Neoplasms/COMPLICATIONSKWDaids-relatedopportunisticinfections/pathologyKWDcandidiasis/pathologyKWDesophagitis/microbiologyKWDesophagitis/pathologyKWDneoplasms/complications
980330
M9831152

Copyright © 1998 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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