CASE 36

History: An 80-year-old man with oxygen- and steroid-dependent chronic obstructive airway disease develops dysphagia and odynophagia.

1. Which of the following should be included in the differential diagnosis of the dominant imaging finding on figure A? (Choose all that apply.)

A. Glycogenic acanthosis

B. Bubbles artifact

C. Candidiasis

D. Cytomegalovirus (CMV) esophagitis

E. Papillomatosis

2. Which of the following distinguishes esophageal Candida infection in an immunocompromised patient from the same occurring in an immunocompetent host?

A. Odynophagia occurs in the immunocompromised patient and dysphagia in the immunocompetent patients.

B. Oral and pharyngeal involvement occurs in the immunocompromised and not in the immunocompetent patient.

C. On barium swallow, the esophagus of the immunocompromised patient presents a “shaggy” appearance, and that of the immunocompetent patient presents a nodular appearance.

D. The infection is identical in both the immunocompromised and the immunocompetent patient.

3. Which of the following statements about esophageal Candida infection is true?

A. Candida albicans is the most common cause of infectious esophagitis.

B. Most of the patients with Candida esophagitis also have clinically visible oropharyngeal thrush.

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