Esophageal candidiasis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Although the appearance of the patches during endoscopy is diagnostic for esophageal candidiasis, biopsies should be obtained to confirm the diagnosis. If the patient is not already diagnosed with HIV or another immunocompromising disease, screening should be done.

Laboratory findings

Microscopic candida examnination

Both smears and biopsies can be stained by periodic acid Schiff stain which stains the walls of the fungi red. Candida also can be stained using gram stain (strongly gram positive)[1]

Candida albicans - By Y tambe - Y tambe's file, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=233284
Candida albicans on Sabaroud agar medium - By Sun14916 - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=18864149
Candida albicans - By GrahamColm - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=10921762
Candida albicans (sputum) - By CDC Brinkman - 1963, Public Domain, httpscommons.wikimedia.orgwindex.phpcurid=2119141

HIV screening in esophageal candida patients

Patients having esophageal candidiasis should be screened for the presence of HIV infection:

Screening Tests

Most HIV tests used to screen for HIV infection detect the presence of antibodies against HIV. Detectable antibodies usually develop within 2–8 weeks after infection, but may take longer. There are three different screening tests:

  1. ELISA test (based on antigen-antibody and enzyme substrate reactions).
  2. Rapid Tests (Dot blot and Latex Agglutination Tests).
  3. Simple Tests (Particle agglutination tests).

Both simple and rapid tests are readily available and cheaper as compared to ELISA although they may not be as sensitive.

Supplemental Tests

These are used to validate results obtained by the screening tests and are of two types:

  1. Western blot tests
  2. Immunofluorescence tests

Confirmatory Tests

These test aim at the following:

  1. Demonstration of viral Antigen (P24).
  2. Isolation of HIV.
  3. Detection of viral nucleic acid.

References

  1. Kumaraswamy KL, Vidhya M, Rao PK, Mukunda A (2012). "Oral biopsy: oral pathologist's perspective". J Cancer Res Ther. 8 (2): 192–8. doi:10.4103/0973-1482.98969. PMID 22842360.

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