# A Rare Case of Candida-Induced Acute Phlegmonous Esophagitis Complicated by Pericarditis and Myocarditis

## TL;DR

A rare case of Candida-induced severe esophagitis with heart complications is reported, emphasizing the need to consider fungal infections in immunocompromised patients.

## Contribution

First documented case of Candida-induced phlegmonous esophagitis with pericarditis and myocarditis.

## Key findings

- Candida species were confirmed as the cause of phlegmonous esophagitis through histopathology.
- The patient developed pericarditis and myocarditis as complications.
- Early antifungal and antibiotic treatment led to clinical improvement.

## Abstract

Acute phlegmonous esophagitis is a rare, life-threatening condition characterized by inflammation of the submucosal and muscular layers of the esophagus. While bacterial infections are the most common etiology, fungal causes are exceedingly rare and poorly documented.​ ​​We report the case of a 50-year-old immunosuppressed man with multiple autoimmune diseases, including Sjögren’s syndrome, primary biliary cholangitis, and autoimmune hepatitis. He had been receiving long-term corticosteroid therapy for disease control. He developed progressive dysphagia followed by acute chest pain and septic shock. Contrast-enhanced computed tomography revealed diffuse esophageal wall thickening with periesophageal fluid accumulation, and endoscopy showed mucosal erythema and circumferential white plaques in the esophagus. Histopathological examination of biopsy specimens confirmed Candida species as the causative organism. Despite the development of pericarditis and myocarditis, early administration of broad-spectrum antibiotics and antifungal therapy led to clinical improvement. This case represents the first documented instance of Candida-induced phlegmonous esophagitis and highlights the importance of considering fungal infections in the differential diagnosis, particularly in immunocompromised patients. Early endoscopic evaluation, histological confirmation, and continuous cardiac monitoring are crucial for accurate diagnosis, management, and detection of cardiac complications.​​​