Candida Esophagitis in Patients with Solid Organ Cancers.

Candida esophagitis (CE) is the most common fungal infection of the esophagus and an increasingly recognized complication in patients with solid organ malignancies. Once primarily associated with advanced HIV/AIDS and hematologic malignancies, the epidemiology has shifted in the modern era of antiretroviral therapy and intensive cancer treatments. Patients with solid tumors receiving chemotherapy, corticosteroids, broad-spectrum antibiotics, and proton pump inhibitors (PPIs) are at a heightened risk for CE due to synergistic immunosuppressive and mucosal barrier-disrupting effects. Clinically, CE in cancer patients often present with odynophagia, dysphagia, or chest pain, but a considerable proportion of cases are asymptomatic or non-specific, complicating diagnosis and needing a high index of suspicion. Endoscopic evaluation with characteristic white plaques and histopathologic confirmation remains the diagnostic gold standard, as symptoms as oropharyngeal findings are unreliable indicators of esophageal infection. Disease management centers on systemic antifungal therapy. Fluconazole is the first-line treatment, achieving high cure rates, while echinocandins and posaconazole are reserved for refractory cases or non-