An Unusual Case of Monilial Oesophagitis

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Abstract
A case of monilial oesophagitis which presented an unusual and difficult diagnostic problem appears worthy of record. R.B.C., a man of 66 years, had been known to suffer from extensive Paget's disease for many years, and had been treated in hospital previously for cardiac failure. He developed increasing dysphagia over six months, and was seen in the X-ray department on 7.2.66 when a barium meal examination showed a possible small gastric ulcer, but no lesion in the oesophagus or duodenum. His dysphagia increased, until he was able to swallow only liquids. He was admitted as an emergency on 19.2.66, with cardiac failure, pyrexia, and severe dysphagia. No cause for the pyrexia could be found. His haemoglobin was 6·1 g per cent, W.C.C. 1,280 cells/mm3 and the sternal marrow appearances were those of an acute “blastic” leukaemia. The source of the infection remained obscure, and a course of penicillin and streptomycin was commenced. There was no evidence of oral ulceration or infection.

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