We report a 35-year-old HIV-1-positive man who presented with severe dyspnea and a nonproductive cough. Three fiberoptic bronchoscopic examination revealed an infiltrating and vegetating tracheal mass that was diagnosed as necrotizing candidiasis of the trachea. The lesion resulted in the formation of a tracheoesophageal fistula that eventually led to the death of the patient. Postmortem examination showed cytomegalovirus vasculitis in the esophageal wall.