Esophageal candidiasis is the most common infectious disease of the esophagus. The
diagnosis is based on gastros- copy, and in many cases, biopsy samples should be taken
as well. If we do not know of any risk factors for an immu- nocompromised condition,
it is a mutual responsibility to confirm or exclude any potential chronic disease
in the background, thus not just the secondary complication but also the primary disease
could be treated. Without this knowledge, in many cases, the correct diagnosis may
be delayed for months or even years, which may risk the suc- cessful treatment. We
present the case of a 58-year-old healthy woman without any chronic disease, who was
referred to our clinic with dysphagia. Due to her complaints we performed a gastroscopy,
upon which advanced esophageal candidiasis was diagnosed, hence she was started on
oral systemic antifungal treatment. Although we could not ex- plore any risk factors,
further investigations behind the immunocompromised condition revealed a positive
immu- noserology test for HIV. The take-home message of our case is that in the case
of esophageal candidiasis, the cause of immunosuppression must be searched for, of
which HIV serology is crucial. Thanks to the prompt and correct diagnosis, we could
start the suitable treatment of the underlying disease.
