THE SEVERITY OF ESOPHAGEAL CANDIDIASIS (CE) ACCORDING TO KODSI'S CLASSIFICATION

Grade I: a few raised white plaques up to 2 mm in size without edema or ulceration

Grade II: multiple raised white plaques greater than 2 mm in size without ulceration

Grade III: confluent, linear, and nodular elevated plaques

Nishimura S et al, Factors Associated with Esophageal Candidiasis and Its Endoscopic Severity in the Era of Antiretroviral Therapy, PLoS One 2013; 8(3): e58217

Grade IV: finding of grade III with increased friability of the mucous membranes and occasional narrowing of the lumen

Initial Management

•Δ of CE was made on the basis: candida white plaques in esophagus on endoscopy, cannot be washed away

•Δ +: Biopsy

–Histology: hematoxylin and eosin and periodic acid-Schiff staining

–Culture for candida species

•Others test: antibiotic use, radiation therapy or chemotherapy, hematologic malignancies, compromised immune system, malnutrition, inhaled corticosteroids

•Treatment: anti-fungal medicine, usually oral fluconazole

Endoscopy severity of Canadian esophagitis (CE) by Kodsi's, http:/www.researchgate.net

Clinical Practice Guideline for the Management of Candidiasis 2016 Updated by the Infectious Diseases Society of America