Esophageal candidiasis in the digestive endoscopy unit of Cotonou’s CNHU-HKM in 2022-2023:epidemiological, diagnostic and therapeutic aspects

Introduction: Oesophageal candidiasis is one of the most common disorders of the oesophagus encountered in digestive endoscopy. The aim of this study was to describe the epidemiological, diagnostic and therapeutic aspects of oesophageal candidiasis at the CNHU-HKM in Cotonou. Methods: This was a cross-sectional, descriptive and analytical study, with retrospective data collection from December 2022 to November 2023. The diagnosis of candidiasis was based mainly on endoscopy, and sometimes histology and/or mycology. Results: In this study, 136 patients were identified out of 1020 admitted for upper gastrointestinal endoscopy (UGIE) at the CNHU-HKM in Cotonou, representing a frequency of 13.3%. The mean age of the patients was 48.2±18.0 years. The sex ratio was 1.3. Information on HIV status was available for 53 patients, of whom 35 (66%) were HIV-positive. Among the clinical indications for UGIE, abdominal pain was the most frequent (38.2%), followed by dyspepsia (16.2%). Dysphagia was frequently found in only 8.1% of patients. Direct examination was positive in 100% of cases (n=20). Candida albicans was the only species found in samples examined by mycology with culture. All patients had received treatment with fluconazole, with an average duration of treatment of 12.1 days +/- 2.7 days. The outcome was favourable in 75% of patients for whom information was available. Conclusion: Oesophageal candidiasis is a relatively common condition in patients referred for OGDE. It is infrequently revealed by dysphagia and confirmed by mycological examination when suspected at endoscopy. Treatment with fluconazole is effective.