Learn about Esophageal Candidiasis (Candidal Esophagitis), a fungal infection of the esophagus. This resource provides information on diagnosis, clinical documentation, and medical coding for Oesophageal Candidiasis, supporting healthcare professionals and coders. Find details on symptoms, treatment, and ICD-10 codes related to Esophageal Candidiasis for accurate and efficient healthcare documentation.
Also known as
Candidiasis of other sites
This code encompasses candidiasis infections in locations not otherwise specified.
Candidiasis of mouth
Includes candidiasis (thrush) affecting the oral cavity.
Candidiasis, unspecified
Used when the specific site of candidiasis infection is unknown.
Diseases of esophagus
Covers various esophageal conditions, though a more specific B code is preferred for candidiasis.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the esophagitis confirmed to be due to Candida?
Yes
Is HIV infection present?
No
Do not code esophageal candidiasis. Code the confirmed diagnosis.
When to use each related code
| Description |
|---|
| Yeast infection of the esophagus. |
| Inflammation of the esophagus lining. |
| Viral infection of the esophagus. |
Coding esophageal candidiasis without specifying the causative organism (Candida) can lead to inaccurate reporting and reimbursement.
Symptoms overlap with GERD, potentially leading to misdiagnosis and incorrect coding of esophagitis instead of candidiasis.
Failing to document and code the underlying immunosuppression contributing to esophageal candidiasis impacts severity and quality metrics.
Q: What are the most effective diagnostic approaches for differentiating esophageal candidiasis from other esophageal disorders mimicking its symptoms in immunocompromised patients?
A: Differentiating esophageal candidiasis from other esophageal disorders, such as herpes simplex virus esophagitis or cytomegalovirus esophagitis, in immunocompromised patients can be challenging due to overlapping symptoms. The most effective diagnostic approach involves a combination of endoscopic evaluation with biopsy and histopathological examination. Endoscopy allows for direct visualization of the esophageal mucosa, identifying characteristic white plaques or pseudomembranes suggestive of candidiasis. However, these findings are not specific. Histopathology, with periodic acid-Schiff (PAS) or Gomori methenamine silver (GMS) staining, confirms the presence of Candida species within the tissue, providing a definitive diagnosis. In cases where endoscopy is contraindicated or not readily available, a careful review of the patient's medical history, including medication use and immune status, alongside consideration of less invasive procedures like barium swallow, can contribute to the diagnostic process. Explore how combining clinical findings with appropriate diagnostic tests enhances diagnostic accuracy in immunocompromised patients. Consider implementing a standardized diagnostic protocol for esophageal disorders in your practice.
Q: Beyond fluconazole, what alternative antifungal treatment strategies are recommended for managing refractory esophageal candidiasis in HIV-positive patients with documented fluconazole resistance?
A: For HIV-positive patients with refractory esophageal candidiasis and documented fluconazole resistance, alternative antifungal treatment strategies are essential. Options include other azoles like itraconazole or voriconazole, which may still be effective if resistance is specific to fluconazole. Echinocandins, such as caspofungin, micafungin, or anidulafungin, are a preferred alternative, particularly in cases of severe or azole-resistant disease. These agents have a different mechanism of action and demonstrate efficacy against most Candida species. Amphotericin B deoxycholate or its lipid formulations are also viable options for severe or refractory cases, although they are associated with more significant adverse effects and require careful monitoring. Treatment duration should be individualized based on clinical response and may extend beyond the resolution of symptoms to prevent relapse. Learn more about optimizing antifungal stewardship to minimize the development of resistance in the future.
Patient presents with complaints consistent with esophageal candidiasis, also known as candidal esophagitis or oesophageal candidiasis. Symptoms include odynophagia, dysphagia, retrosternal chest pain, and occasionally nausea or vomiting. The patient reports difficulty swallowing, particularly with solid foods. Clinical examination may reveal white plaques or pseudomembranes on the esophageal mucosa. The patient's medical history includes recent antibiotic use and a mildly compromised immune system due to well-controlled type 2 diabetes. Differential diagnosis includes gastroesophageal reflux disease (GERD), esophageal spasm, and other infectious esophagitis. Diagnosis is confirmed via endoscopic visualization with biopsy and culture demonstrating Candida species, specifically Candida albicans. Treatment plan includes oral fluconazole or other appropriate antifungal medication for a duration determined by clinical response. Patient education provided regarding medication compliance, dietary modifications, and management of underlying conditions. Follow-up endoscopy may be considered to assess treatment efficacy. ICD-10 code B37.8 is recorded for esophageal candidiasis. This diagnosis and treatment are consistent with established clinical guidelines for the management of esophageal candidiasis in patients with similar risk factors and clinical presentation. The patient is advised to return for further evaluation if symptoms worsen or do not improve with prescribed therapy.