Foamy esophagus sign

Last revised by Daniel J Bell on 2 Apr 2023

The foamy esophagus sign is an appearance seen on a single contrast barium study in Candida esophagitis with associated scleroderma/achalasia (stasis).

The pathophysiologic basis of the foamy esophagus sign is uncertain. Stasis is a predisposing factor. Foam is produced directly by the fungal organisms that colonize the esophagus due to the production of carbon dioxide via oxidative respiration.

The foamy esophagus appearance is characterized by multiple tiny (1-3 mm), round lucencies that are mixed with the barium suspension along the top of the barium column, producing a layer of foam.

Other fluoroscopic signs of Candida esophagitis include:

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