We reviewed 20 esophageal biopsy specimens from 180 adult patients with the acquired immunodeficiency syndrome (AIDS). Ten (50%) showed superficial Candida infection, and four revealed esophagitis due to cytomegalovirus. Candida was never invasive, even though it was associated with significant ulceration. Esophageal candidiasis did not necessarily imply the presence of oral candidiasis, and conversely, oral candidiasis did not imply esophageal candidiasis. Odynophagia was associated with significant histologic ulcerations in eight of ten patients. In the patients who had odynophagia, biopsy was almost equally likely to show Candida or viral cytopathic effect. We discuss the clinicopathologic implications of these findings.
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