White Esophagus: The Result of Polypharmacy

Candida esophagitis can occur in immunocompetent patients through impairment of host defense mechanisms including salivation, esophageal motility, acidic pH, and innate immunity. Commonly prescribed medications inhibit these mechanisms, and polypharmacy has been shown to have an additive effect on promoting Candida infection. We present the case of an immunocompetent patient who was chronically prescribed multiple medications associated with Candida esophagitis but experienced infection only after the addition of oral delayed-release budesonide, which has not previously been associated with Candida esophagitis.