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The "Foamy" Esophagus

A Radiographic Sign of Candida Esophagitis

Joseph W. Sam1, Marc S. Levine, Stephen E. Rubesin and Igor Laufer

1 All authors: Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.



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  		Fig. 1. —30-year-old woman with scleroderma. Double-contrast esophagram shows innumerable tiny, round lucencies (bubbles) in thoracic esophagus, producing foamy appearance. Patient had distal peptic stricture (not shown).

 


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  		Fig. 2. —72-year-old woman with scleroderma. Double-contrast esophagram shows tiny lucencies in thoracic esophagus. Foam (arrow) layers at top of barium column. Patient also had distal peptic stricture (not shown).

 


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  		Fig. 3. —68-year-old woman with scleroderma. Double-contrast esophagram shows foam (white arrow) layering in distal esophagus along top of barium column. Note similarity of findings to those seen in Figure 2. Peptic stricture (black arrow) also is faintly seen in distal esophagus.

 


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  		Fig. 4. —51-year-old woman with scleroderma. Double-contrast esophagram shows foam (curved arrow) layering out in distal esophagus along top of barium column. Adherent foam and nodular mucosa are also seen in mid esophagus above barium column. Note mild peptic stricture (open arrow) and esophageal intramural pseudodiverticula (solid straight arrows) in distal esophagus.

 


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  		Fig. 5. —41-year-old immunocompromised woman. Double-contrast esophagram shows innumerable tiny lucencies in lower half of esophagus that layer (curved arrow) along top of barium column. Note irregular narrowing (straight solid arrow) and intramural tracking (open arrow) of distal esophagus due to underlying Candida esophagitis.

 

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