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Original Article

Esophageal Candidosis in Progressive Systemic Sclerosis: Occurrence, Significance, and Treatment with Fluconazole

, , , &
Pages 1182-1186 | Received 07 Jun 1988, Accepted 29 Jul 1988, Published online: 08 Jul 2009
 

Abstract

Esophageal mucosal brushings from 51 consecutive patients with progressive systemic sclerosis (PSS) (group I), 18 PSS patients continuously treated with high-dose ranitidine or omeprazole (group II), 34 controls referred to the outpatient clinic for endoscopy (group III), and 10 patients receiving long-term potent antireflux therapy for idiopathic gastroesophageal reflux (group IV) were cultured for Candida albicans. There were 44%, 89%, 9%, and 0% Candida albicans culture-positive patients in groups I through IV, respectively. Fifteen patients with Candida esophagitis from group II were treated with fluconazole systemically. Eleven and 14 patients became culture-negative after 2 and 4 weeks' treatment, respectively. Three months after fluconazole withdrawal the recurrence rate was 100%. It is concluded that esophageal dysmotility predisposes for candidosis. Adding gastric acid inhibitory treatment to dysmotility enhances the risk significantly (p < 0.01). The efficiency of fluconazole treatment was close to 100%, but so was the recurrence rate within a short period.

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