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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ante mortem diagnosis of herpetic esophagitis has been made in four immunosuppressed patients with cancer. The diagnosis was made by brush cytology at the time of esophagoscopy. All four patients had severe dysphagia unresponsive to nystatin therapy and the diagnosis of herpes infection excluded the use of Amphotericin B for resistant moniliasis. The diagnosis of herpes virus infection of the esophagus has been previously made almost exclusively at post mortem examination. Herpetic esophagitis is shown to be not necessarily a preterminal complication in cancer patients. In three of the four patients the esophagitis resolved as the patients responded to anti-tumor therapy.
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PMID:Herpetic esophagitis in patients with cancer: ante mortem diagnosis by brush cytology. 18 38

Herpetic esophagitis is an infrequent ulcerative infection of the esophagus caused by Herpes Virus type I. It is usually seen in immunocompromised patients though it may present in immunocompetent ones. Odynophagia and/or dysphagia associated with chest pain are the most frequent clinical symptoms. Radiology, endoscopy, biopsy and serological markers are the basis for diagnosis. We report 3 patients with herpetic esophagitis diagnosed between 1984-1989 and evaluated the clinical, endoscopic and biopsy characteristics. Certain clinical and endoscopic findings common to our patients tend to identify the disease, with biopsy and or serological markers the diagnosis may be established.
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PMID:[Herpetic esophagitis]. 196 85

The topic of esophagitis due to Candida (ED), the most frequent infection of the esophagus, is reviewed. In recent years we have seen increased interest in candida esophagitis, fundamentally due to its relation with AIDS, for which it constitutes a diagnostic criteria. Candida esophagitis, although it can appear in apparently healthy subjects, is usually associated with processes that impair the immune system, as well as with local lesions of the esophagus. The typical clinical presentation is as odynophagia, dysphagia and/or retrosternal pain, although asymptomatic forms are frequent, and its association with oropharyngeal candidiasis is variable. Oral endoscopy is the diagnostic technique of choice, since it permits samples to be taken for histologic and cytologic study and cultures; cytology is the most sensitive and specific technique. The differential diagnosis should be made fundamentally with other infectious esophagitis pictures, particularly herpes, and with reflux esophagitis. Treatment is based on antifungal drugs, most frequently nystatin, amphotericin B and ketoconazole.
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PMID:[Esophagitis caused by Candida albicans]. 268 35

Viral esophageal infection is common in immunocompromised patients. Twelve patients with esophagitis secondary to herpes viruses are described. Odynophagia, dysphagia, and gastrointestinal bleeding were the most common symptoms. Multiple infections particularly with candida were present in three of the 12 cases (25%). Typical "volcano ulcers" at endoscopy and discrete diffusely scattered shallow ulcers seen on double contrast esophagram are highly suggestive of herpetic esophagitis. Single contrast esophagram plays no specific role in the diagnosis of herpetic esophagitis. An analysis of clinical, endoscopic, radiological, and pathological features is presented.
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PMID:Herpetic esophagitis: a diagnostic challenge in immunocompromised patients. 396 49

A homosexual man with AIDS developed multifocal KS with involvement of the palate, larynx, trachea, and esophagus. Symptoms included dysphagia and gagging with resultant inanition. Short-course local radiation therapy effectively resolved the mucosal KS lesions in the treated areas. Other otolaryngologic manifestations included herpes stomatitis and oral candidiasis.
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PMID:Pharyngeal obstruction by Kaposi's sarcoma in a homosexual male with acquired immune deficiency syndrome. 644 93

Drug induced esophageal ulcers are more frequent than supposed. Four ulcerative lesions of the esophagus, two after ingestion of doxycycline-hydrochloride, one after metacycline-hydrochloride, and one after emeproniumbromide were detected at the department of Internal Medicine of a medium-sized standard-hospital during the last six years. Symptoms develop suddenly after taking the drug with minimum fluid, usually before going to bed. Retrosternal burning, odynophagia and dysphagia are pathognomonic features. The cause of ulceration is discussed to be a matter of the drug remaining in the esophagus and of its local cytolytic and corrosive effect. Cytomegalo and herpes-simplex-infections can be excluded as etiologic factor of such ulcers. The clinical diagnosis is verified by endoscopy only.
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PMID:[Drug induced esophageal ulcers]. 715 2

Inflammatory changes of the oesophageal mucosa are in the vast majority due to reflux of gastric content. Caustic oesophagitis is rare, however, drug-induced oesophageal injury caused by delayed passage is of increasing importance. Infections by opportunistic saprophytes (candida, herpes virus) are common causes of oesophagitis in immunocompromised patients with dysphagia and odynophagia whereas specific inflammation (Crohn's disease, tuberculosis) is a rarity. Successful therapy demands precise differentiation of the different forms of oesophagitis.
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PMID:[Spectrum of esophagitis: etiology, diagnosis, therapy]. 727 52

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.
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PMID:[Diagnosis and treatment of esophageal ulcers in patients seropositive for the human immunodeficiency virus (HIV-positive)]. 839 77

In the gastroenterological diagnostic armamentarium, dysphagia is considered as an important symptom for diseases of the esophagus. Concerning the history of illness, symptoms such as retrosternal pain and heartburn are often associated with gastroesophageal reflux disease. Morphological changes of the mucosa can be diagnosed by flexible endoscopy and radiographic examinations. Investigation with 24-h pH monitoring, manometry, and pharmacological tests is necessary for the diagnosis of functional disorders. Additionally, dysphagia can be associated with multiple internal diseases, including muscular diseases such as dermatomyositis, progressive systemic sclerosis, as well as lupus erythematosus. Difficulties in swallowing associated with hypo- and hyperthyroidism can also be interpreted as muscular lesions. Metabolic disorders such as alcoholism, and diabetes mellitus can be the cause of dysphagia. Increasing importance in the differential diagnosis of dysphagia is attached to infections of the upper GI tract. Especially in immunocompromised patients, infections of Candida albicans, mycobacterias, herpes, varicella zoster, and cytomegaloviruses can produce dysphagia and odynophagia. The differential diagnosis of the "angina-like chest pain" has to differentiate between cardiac disease and a noncardiac genesis. Therefore, besides the cardiac diagnostic investigation, endoscopy, radiography, and manometry are often indicated.
Dysphagia 1993
PMID:The gastroenterologist's approach to dysphagia. 846 28

Infection by neurotropic viruses, as exemplified by the herpes family, is universally accepted as a cause of palsies of the cochleo-vestibular and facial nerve. Palsies of the vagus nerve with a possible viral etiology have been described, although viruses have been identified in only a few selected cases. We report a 52-year-old man with unilateral otalgia, hoarseness and dysphagia. Examination revealed unilateral (left-sided) pharyngeal dysfunction, and paralysis of the left vocal cord fixed in the paramedian position. A barium swallow documented dysfunction of the left pharyngeal constrictor muscles. These findings suggested the lesion to be located either at the inferior ganglion of the vagus nerve or cranially. At direct laryngoscopy a smear was obtained from a 4-mm mucosal ulcer at the region of the left arytenoid cartilage. This smear demonstrated antibodies to herpes simplex virus (HSV) type I by immunofluorescence. On follow-up 19 months after the initial infection there was complete remission of the paralysis of the left vocal cord and normal pharyngeal function. The demonstration of HSV type 1 antibodies from a mucosal lesion in the distribution of the superior laryngeal nerve suggests that reactivation of HSV type I was the most likely explanation for the temporary nerve palsy seen.
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PMID:Herpes simplex virus type I reactivation as a cause of a unilateral temporary paralysis of the vagus nerve. 873 89


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