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M94A0292.TXT
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1994-10-08
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Document 0292
DOCN M94A0292
TI The natural history of esophageal candidiasis after successful treatment
in patients with AIDS.
DT 9412
AU Laine L; Division of Gastrointestinal and Liver Diseases, University of;
Southern California School of Medicine, Los Angeles.
SO Gastroenterology. 1994 Sep;107(3):744-6. Unique Identifier : AIDSLINE
MED/94357372
AB BACKGROUND/AIMS: Antifungal therapy cures esophageal candidiasis in most
patients with acquired immunodeficiency syndrome, but the subsequent
course of these patients is not established. This study examines the
natural history of esophageal candidiasis after successful treatment.
METHODS: Patients with endoscopic and clinical resolution of esophageal
candidiasis after therapy were followed up prospectively with monthly
clinical assessment and repeat endoscopy every 3 months or earlier if
esophageal symptoms recurred or if the patient was to begin antifungal
therapy for another reason. RESULTS: Thirty-five patients met entry
criteria; 21 agreed to enroll. The patients were followed up for a mean
of 23 +/- 4 weeks after their initial posttreatment endoscopy. Nineteen
patients (90%) had recurrent esophageal candidiasis at a mean of 11 +/-
2 weeks (range, 3-36 weeks). The 19 patients had 31 recurrences; 25
(81%) occurred < or = 10 weeks after documented cure of the prior
episode of esophageal candidiasis. Twenty-two (71%) of the 31 recurrent
episodes were symptomatic, and only 9 (29%) were associated with oral
thrush. All symptomatic recurrences responded to treatment with
fluconazole; 1 of 22 (5%) failed to show endoscopic resolution.
CONCLUSIONS: Almost all patients with acquired immunodeficiency syndrome
and successfully treated esophageal candidiasis develop a recurrence,
usually within 2-3 months. Two thirds are symptomatic and one third are
associated with oral thrush. Subsequent episodes of esophageal
candidiasis respond well to oral therapy.
DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Antifungal
Agents/THERAPEUTIC USE Candidiasis/*COMPLICATIONS/*DRUG
THERAPY/PHYSIOPATHOLOGY Esophageal Diseases/*COMPLICATIONS/*DRUG
THERAPY/PHYSIOPATHOLOGY Fluconazole/THERAPEUTIC USE Follow-Up Studies
Human Recurrence JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).