RARE CAUSES OF ACUTE ESOPHAGITIS WITH SEVERE DYSPHAGIA IN CHILDREN

Smaranda Diaconescu, Cristina-Gabriela Șchiopu, Nicoleta Gimiga, Stefana Maria Moisa, Gabriela Ghiga, Lorenza Donea, Gabriela Ștefănescu, Oana-Maria Roșu

ABSTRACT Esophagitis in pediatrics could have various causes, such as acid and non-acid gastroesophageal reflux, food allergies, infections, trauma, and iatrogenic causes. A three year old patient was admitted into the General Pediatrics department in our hospital for abdominal pain, vomiting, dysphagia, mild diarrhea, loss of appetite, fever (39°C) , with the onset of the symptomatology occurring 4-5 days prior to hospital admission. Clinical exam reveals dysphagia for liquids and solids and diffuse abdominal pain. Upper gastrointestinal endoscopy reveals an esophagus with multiple ulcerations and aphthoid-type lesions, as well as a friable mucosa that bleeds easily in contact with the endoscope. Candida albicans was found in feces. Considering the negative anamnesis for ingestion of corrosive substances, the case raises the suspicion of lesions associated with Candida albicans or of a viral etiology. The treatment with proton pump inhibitors, antimycotics, and preparations with antiviral and immunomodulatory actions determined a rapid favorable evolution. The inflammatory lesions of the esophagus can be varied, often having non-specific aspect. The endoscopic modifications of the mucosa are extremely typical in some cases. Careful differential diagnosis is mandatory, as in the long term all types of untreated esophagitis can become complicated by the development of esophageal stenoses.

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