Oesophageal tuberculosis with concomitant candidiasis: a rare cause of dysphagia

BMJ Case Rep. 2019 Nov 2;12(11):e231435. doi: 10.1136/bcr-2019-231435.

Abstract

We present a case of a 23-year-old woman with dysphagia. She was reportedly newly diagnosed with HIV and had been initiated on antiretroviral treatment and tuberculosis (TB) prophylaxis. Oesophagogastroduodenoscopy revealed an irregular, ulcerative oesophageal lesion. Subsequent histopathology revealed M ycobacterium tuberculosis as well as C andida albicans A CT scan demonstrated widespread disease with miliary TB. She was subsequently initiated on antituberculous and antifungal medications. TB is one of the most common and deadly infectious diseases in the world, with the highest rates seen in the developing countries. It commonly occurs as an opportunistic infection of HIV. Despite its potential for systemic infection, infection of the oesophagus is incredibly rare, more so as a co-infection with candida. This case highlights the need to have a high index of suspicion in high risk groups, as early treatment is crucial in addressing this global health crisis.

Keywords: TB and other respiratory infections; endoscopy; infection (gastroenterology); respiratory system; ulcer.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Antitubercular Agents / therapeutic use
  • Candidiasis / complications*
  • Candidiasis / diagnosis
  • Candidiasis / drug therapy
  • Deglutition Disorders / etiology
  • Esophageal Diseases / pathology*
  • Female
  • Fluconazole / therapeutic use
  • HIV Infections / complications
  • Humans
  • Mycobacterium tuberculosis / isolation & purification
  • Tomography, X-Ray Computed
  • Tuberculosis / complications*
  • Tuberculosis / diagnostic imaging
  • Tuberculosis / drug therapy
  • Young Adult

Substances

  • Antifungal Agents
  • Antitubercular Agents
  • Fluconazole