An HIV-infected patient may develop a giant ulceration in the esophagus. It is essential to determine the cause, since this will determine the most effective management.
(1) painful swallowing (odynophagia)
(2) acute substerrnal chest pain
(3) hematemesis or GI bleeding
(4) single large ulceration or multiple small ulcerations in the mid to distal esophagus
(5) superinfection of the ulcers by Candida albicans may occur
intranuclear inclusions or positive viral cultures
history and type of oral medications
change in formulation, drug regimen or route of administration
exclusion of other causes
acid fast bacilli and culture
nasogastric intubation or endoscopy
history of recent intubation or endoscopy attempt
chemical burn of lips, mouth and esophagus
history of radiation therapy to chest
• Some cases of HIV-related ulceration will occur as part of the primary infection.
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Purpose: To evaluate an HIV-positive patient with a giant esophageal ulceration.
Objective: clinical diagnosis, including family history for genetics, complications
ICD-10: B23.8, K22.1,