Refractory esophagitis caused by <i>Candida nivariensis</i>: second description of this yeast in Brazil and a literature review.

<i>Candida nivariensis</i> caused refractory esophagitis in a 36-year-old Brazilian man coinfected with HIV and <i>Leishmania</i>. A literature review on this rare fungal pathogen is also presented. The diagnosis was made, and pathogen identification was performed using matrix-assisted laser desorption ionization-time of flight mass spectrometry and sequencing of the <i>LSU/26S</i> region. An antifungigram was performed using broth microdilution. A literature search of PubMed was performed. The causative agent, <i>C. nivariensis</i>, was resistant to fluconazole and voriconazole. The patient's condition worsened considerably, and he passed away. This is the second report of this <i>Candida</i> species in Brazil and the first case reported worldwide of refractory esophagitis in a patient coinfected with HIV and <i>Leishmania</i>. The case illustrates the importance of precise identification and antifungal susceptibility testing when isolating this emerging pathogen.