[Diagnosis and treatment of esophageal ulcers in patients seropositive for the human immunodeficiency virus (HIV-positive)].
Esophageal ulcers are often found in patients with human immunodeficiency virus infection. We have retrospectively reviewed the upper endoscopies performed in these patients during the last four years. 149 examinations were realized in 73 patients. Fourteen patients with esophageal ulcers were diagnosed. A severe immunological impairment was present in all patients (CD4 24.4 +/- 31.1 cells/ul). Symptoms were non-specific, with prevailing dysphagia and odynophagia. The etiological diagnosis was reached by histological studies and cultures in 5 cases (36%), three due to Herpes virus type I, one due to Cytomegalovirus and another one to Mycobacterium tuberculosis. Patients with multiple ulcers or small ones were successfully treated with antiviral drugs, even when the etiological studies were negative. Corticosteroids were useful in single and large ulcers in which diagnostic tests were negative.
Servicio de Aparato Digestivo, Hospital de Bellvitge Prínceps d'Espanya.
G
G
Fernández Esparrach
J
J
Castellote
X
X
Xiol
J
J
Guardiola
M
M
Santín
R
R
Rota
D
D
Podzamczer
J M
JM
Miquel
D000328:Adult; D004935:Esophageal Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014456:Ulcer / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy