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).