Abstract: Objective To sum up the experience in diagnosis of fungal esophagitis. Methods An analysis was performed on clinical data of 38 cases of fungal esophagitis diagnosed through gastroscopy in Peking Union Medical College Hospital from 2013 to 2015. Results Of 38 cases, 26 were males and 12 were females. The mean age was （54.0±1.5） years old. 76.3% had at least one risk factor. 7 patients had oral candidiasis and 10 patients had typical symptom of fungal esophagitis. Endoscopic severity was classified according to Kodsi’s grade: gradeⅠ 6 cases, grade Ⅱ 29 cases, grade Ⅲ 1 case，grade Ⅳ 2 cases. Most patients were treated with systemic antifungal therapy. However, one patient’s fungal esophagitis resolved without any treatment. Conclusions Endoscopy with biopsy is a valuable definitive diagnostic method for fungal esophagitis, especially for asymptomatic patients or those without oral candidiasis. Systemic antifungal treatment is recommended with fluconazole as the first choice. Further studies are needed to determine if systemic antifungal therapy is necessary for asymptomatic and immunocompetent patients with mild fungal esophagitis.

Key words: fungal, esophagitis, diagnosis