Human Immunodeficiency Virus Book

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Dysphagia in HIV

Aka: Dysphagia in HIV, Odynophagia in HIV
  1. See Also
    1. Dysphagia
    2. Gastrointestinal Manifestations of HIV
    3. HIV Complications
  2. Epidemiology
    1. Dysphagia or odynophagia occurs in 40-50% HIV patients
  3. 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 Ulcer or pill-induced ulcers (less frequent)
  4. 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
  5. Diagnosis: Endoscopy
    1. Biopsy and brushings
    2. Culture for virus, Mycobacterium, and fungus
  6. Management
    1. Anti-Candida treatment can be tried
    2. Failure to respond in 24-48 hours requires endoscopy

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