İnhale Steroid Kullanımı Sonucu Gelişen Özofageal Kandidiazis

71 yaşında kadın hasta disfaji, odinofaji ve dispne şikayetleriyle başvurdu. 20 yıldır astım tanısı ile takip edilen ve daha önce düzensiz olarak inhale flutikazon propionat ile tedavi edilmiş olan hasta, son 10 gündür düzenli olarak inhale flutikazon propionat tedavisi alıyordu ve halen bu tedavinin 9. günündeydi. Hastaya özofagoskopi yapıldı. Endoskopide özofagus lümeninde mukozayı diffüz olarak tutan ve özofagusun alt kısmında yer yer lümeni daraltan beyaz, kirli sarı plaklar vardı. Endoskopi bulguları kandida özofajiti ile uyumluydu. 14 günlük antifungal tedavi sonrası yapılan kontrol endoskopisinde bu kandida plaklarının tamamen kaybolduğu görüldü. İnhale steroid tedavisi alan ve odinofaji şikayeti ile başvuran hastalarda ayırıcı tanıda kandida özofajiti akılda tutulmalıdır

Esophageal Candidiasis As a Complication of Inhaled Steroid Therapy

A 71 years old female was presented with dysphagia, odynophagia and dyspnea. She has been followed with asthma for 20 years. She had used inhaled fluticasone propionate irregulerly previously and she has been treated with inhaled fluticasone propionate 2 mg 2x1 for nine days.Esophagoscopy was performed for the suspection of candida esophagitis. On endoscopy, diffuse white-yellow plaques scattered over the mucosa of the esophagus diffusely and a narrowed lumen the lumen at the inferior part of esophagus was seen. The diagnosis was candida esophagitis. After the antifungal treatment, all the candida plaques dissapeared completely. Candida esophagitis should be kept in mind in the differential diagnosis of the patients odynophagia who were treated with inhaled steroids as a differential diagnosis

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