Opportunistic esophagitis in AIDS: radiographic diagnosis.
Thirty-five of 90 patients with acquired immunodeficiency syndrome (AIDS) seen between 1983 and 1986 underwent esophagography (double contrast in all but two) to rule out opportunistic esophagitis; 20 of the 35 were found to have fungal or viral esophagitis. A radiographic diagnosis of Candida esophagitis was made in 17 patients because of varying degrees of plaque formation. Seven of those patients had a grossly irregular or "shaggy" esophagus; in four, the diagnosis of AIDS was initially suspected from this finding. In the remaining three patients, a radiographic diagnosis of viral esophagitis (herpes simplex in two and cytomegalovirus in one) was made because of discrete ulcers on a normal background mucosa. Eighteen patients had endoscopic, clinical, or autopsy findings that corroborated the radiographic diagnosis; follow-up data were not available for two patients with Candida esophagitis. This experience suggests that fungal and viral esophagitis can often be differentiated with double-contrast esophagography, enabling appropriate antifungal or antiviral therapy to be instituted without endoscopic intervention.
Levine
M S
MS
Department of Radiology, Hospital, University of Pennsylvania, Philadelphia 19104.
Woldenberg
R
R
Herlinger
H
H
Laufer
I
I
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D002177:Candidiasis / Q000000981:diagnostic imaging*; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004941:Esophagitis / Q000000981:diagnostic imaging*; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006561:Herpes Simplex / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies
D001466:Barium Sulfate