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Am I infected with candida oesophagitis?

Dr Anuj Sharma
World Health Organization,
Country Office for India,
New Delhi

Q: I have been exposed to unhygienic environment of fungi, mould and many bacteria and viruses. I searched on the Internet and found that I have all the symptoms arising from living in an environment of fungi and mould. I found that I have candida and forms of it. This all started when I was looking for chest pain and found that I have Candida oesophagitis. The reason I am sure about all these symptoms is because I have went through at least 200 different webpages in the last one week. And all of them seem to be saying the same thing that these are the symptoms of different fungi and mould allergies/infections etc. Since I have been exposed to different kinds of fungi and bacteria, is there any test that could look for how deep rooted that problem is? I mean if it is Aspergillosis or invasive candidiasis or in general how much damage is there? All the symptoms for different kinds of moulds and fungi are the same, but the treatment is different as all antifungals like Fluconazole etc. don't seem to be effective for all kinds of fungi problems. Is there a test that could help me find out how bad is the fungus in my body - like invasive in different organs? if nothing is severe then should I take Fluconazole 100 mg for 14 to 21 days and see if all symptoms go away? Would Fluconazole treatment help?

A:You have not mentioned how you arrived at the diagnosis of candida infection of the oesophagus. You should be aware that fungi and bacteria are all around us in the environment, and a lot of them, including candida and a large number of bacteria, are a part of the normal flora of our body - in the mouth, intestines, skin, vagina, etc. The body has defence mechanisms in place not to let these commensals become pathogens and cause disease. However, in some situations, these organisms that form a part of the normal human flora, can become opportunistic pathogens, but these situations are seen in hospitalised patients, and are extremely rare in out-patients. In your case, please do not worry too much. There is no role of starting any treatment without a definitive diagnosis as most of these drugs have side effects and cannot be used without medical supervision. A visit to a physician for a physical examination, and if required an endoscopy, will remove all your doubts.