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The Old Endoscopy Quiz (and Answer) of the Month
January 2007

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Question:

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This old man came to an upper endoscopy as he had experienced some quite painful swallowing for several months. He had a chronic obstructive pulmonary disorder and used prednisolon daily perorally about 15 mgs. This was the finding in the oesophagus. What is this?

Answer:

Candida-Oesophagits, caused by glucocorticoid treatment, Kodzi Grade III.

Candida oesophagitis

Candida oesophagitis An oesophageal inflammation due to candida, and the most common type of nonpeptic oesophagitis. Predisponing factors are diabetes, corticosteroid treatmen (also as aerosols in the treatment of bronchial asthma), antibiotic treatment and malignancies, especieally if treated with immunosuppressive drugs. The typical endoscopic finding is whitish plaques that in severe cases may be confluent. The best treatment is removal of the predisponing factor, if possible. Candica oesophagitis is often strikingly symptomfree but can cause odynophagia.

Candida oesophagitis grade 1 according to the Kodsi classification

Kodsi classification of candida oesophagit was introduced by BE Kodsi in 1976. The severity of candida oesophagitis is classified into four degrees: Grade I: A few small candida plaques up to 2 mm in size, with mucosal hyperemia but wihtout oedema or ulcerations Grade II: Multiple bigger white candida plaques with mucosal hyperemia and oedema but without ulcerations Grade III: Confluent linear candida plaques with mucosal hyperemia and ulcerations Grade IV: As grade III but with constricion of the oesophageal lumen.

Correct answers and comments were emailed by

PARABOLI SILVA, Marcio Luiz, Sao Jose do Rio Preto-SP-, SAO PAULO
Salvatore Della Ducata, Gallipoli, Italy
Ervin Toth, Malmö, Sweden
Ali Shakir, Worthing, UK
amrani khalil, constantine, Algeria
Jonas Ekström, Sala, Sweden
Israel Grilo, Seville, Spain
Petr Vozeh, Praha, Èesko
Ma³gorzata Ferenc, Olsztyn, Poland
Lig HO, Hong Kong, China


A perfect dinner spot in Greece ©
Lavrentios Papalavrentios, Thessaloniki, Greeece
CARLOS ALBERTO GHETTI, JUIZ DE FORA, BRAZIL
Dr said MAHMOUD, Riyadh, KSA
RASSIAT, DIJON, FRANCE
Marcel Cina, Presov, Slovakia
Fernando Peres. Rio de Janeiro, Rio de Janeiro, Brazil
Antonio Siqueira, Brasilia, Brazil
radu ionescu, Bucharest, Romania, .... and a warm welcome to the European Union, by the way!
Ziad Daoudi, Fairfield, USA
Albert J. Chang, Los Angeles, California
Trinh Truong, Los Angeles, California
dongjun fan, Taiyuan, China
Dr.Zuhair Homsi, Dammam, Saudi Arabia
annet zacks, CA. USA
Lukac, Bratislava, Slovak Republic
Debashis Chowdhury, Rangpur, Bangladesh
Tsiaousi Eleni, Thessaloniki, Greece
dr.ashok mittal, Rohtak, India/Haryana
m.lerios, Nicosia, Cyprus
fahri akyüz, Izmit, Turkey
Bacci, Bragança Paulista, Brazil / São Paulo
rashedhassen, Fakous, Egypt
Dr.ARBER Veliu, Prishtina, Kosova
HOUR DY, Phnom Penh, Cambodia
Christina Ecclissato, Campinas, Brazil
Dimitris Kounios, Athens, Greece
German Lloret Salom, Alzira, Spain
Ho Dang Quy Dung, CR hospital, Ho Chi Minh, Vietnam
dr.shabbir ahmed.k, bangalore, India / Karnataka
Zlatko Bulic, Croatia
Jan Kirchner,MD, Karlovy Vary, Czech Republic
erturk, Ankara, Turkıye
Çetin KARACA, İstanbul, Turkey
Grzegorz Naprawa, Szczecin, Poland
Kwitek-Socha Halina, Gdansk, Poland
kkeshk, London, UK
Margie Annis, Brooksville, USA/FL
Jan Westerink, Lunteren, Netherlands
saliminejad, LA, USA
alireza momeni, Tehran, Iran
mirela popa, Bucharest, Romania.... and a warm welcome to the European Union, by the way!
CELALETTİN CETİN, BURSA, TURKEY
Charlotte Beattie, Hawthorne,NJ, USA
Marc Kudisch, Houston, USA/Texas
Zlatko Bulic, Pula, Croatia
Cevale Karslioglu Sgouros, Istanbul, Turkey
rafat moussa, sokoto Nigeria
anıl özmutlu, Hakkari, Turkiye
kerrie pascoe, Brisbane, Australia
Dott. Dario Gambaccini, Livorno, ITALY
waseem zakaria, aleppo, Syria
R.K.Linskens, Mierlo, The Netherlands
jcs, San Antonio, Texas
kyounginn Kim, Seoul, South Korea
Claudia Iacobescu, Bucharest, Romania.... and a warm welcome to the European Union, by the way!
Mansour Al Shehadat, Damascus, Syria
fred stam, Haarlem, Holland
demi, Paris, France
neelima reddy
Salvatore de Marco, Pisa, Italy
Tuba Nazlıgül, Ankara, TÜRKİYE
Matthew Timm, Pender, U.S.A./Nebraska
Zahreddine Radwan, Beirut, Lebanon
Juan Carlos Munoz, Jacksonville, USA
Felix Olobatuyi, Cleveland, Ohio
Hyeonseong Kim, Seoul, South Korea
JAMSHID, Klaipeda, Lithuania
Van Thielen Jana, Edegem, Belgium
Cheryl Lynch, Erie, PA, USA
Kathleen Franks, Souderton, PA, USA
Mujdat Zeybel, Manisa, Turkey
THAMER H,HUSSEN, DOHA, QATAR
KLAUDIA J.Niepsuj, Gliwice, Poland
u cuartas, Augusta, USA
pg, smithville, ar
German Lloret Salom, Alzira, Spain
William Fullick, Norwich, UK

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