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Dysphagia in HIVAka: Odynophagia in HIV

Epidemiology
1. Dysphagia or odynophagia occurs in 40-50% HIV patients
Causes
1. Candida most frequent pathogen (50-70% of cases)
2. Viral (30% of cases)
  1. Herpes Simplex Virus
  2. Cytomegalovirus Infection
3. Polymicrobial: 20-25% cases
4. Aphthous or pill-induced ulcers (less frequent)
Signs
1. Mucosal Plaques, Erosions or Ulcerations
2. External compression from nodes or masses
3. Oral Thrush
  1. Indicator (70-80%) for esophageal involvement
  2. Oral Thrush seen in 62% of esophageal Candidiasis
Diagnosis: Endoscopy
1. Biopsy and brushings
2. Culture for virus, Mycobacterium, and fungus
Management
1. Anti-Candida treatment can be tried
2. Failure to respond in 24-48 hours requires endoscopy

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.