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

A case of laryngeal involvement by herpes virus is reported. Its appearance suggested an extensive neoplasm. Laryngeal herpes infection is uncommon, but the wide spectrum of forms of onset, from banal laryngitis to severe airway obstruction, hoarseness, or dysphagia, require accurate differential diagnosis to establish an effective treatment and follow-up.
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PMID:[Herpetic laryngeal involvement simulating neoplasm]. 913 32

The goal of this paper is to report an interesting case of laryngeal involvement by herpes virus, showing a morphological aspect very alike to an extense neoplasm of this region. Laryngeal involvement of herpes virus is a clinical infrequent entity, but as its wide onset forms range from a banal laryngitis until a severe airway obstruction, hoarseness or dysphagia, it seems mandatory an accurate differential diagnose to settle a treatment and the effective follow-up.
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PMID:[Herpetic pseudotumor laryngitis]. 1009 63

Herpetic gingivostomatitis (HGS) is the predominant manifestation of cutaneomucosal herpes in children with HSV1 primary infection before the age of 3 years. The infection is self limiting and lasts 10 to 14 days. Pain and dysphagia are particularly important during the first week of infection and may necessitate parenteral rehydratation and administration of antalgesics. HGS in the young child causes substantial morbidity leading to hospital and social costs (work stoppage for parents). The clinical course is generally benign with the exception of forms with important extension, eczema, herpeticum Kaposi-Juliusberg pustulosis observed at this age only in children with atopic dermititis. Other severe forms are observed in the neonate and immunodepressed subject, which can also be caused by HSV1. Forms with little or not clinical manifestation predominate and generally go undiagnosed, explaining the asymptomatic viral excretion observed in the saliva or other secretions (ocular, genital secretions). Despite the sterotypic nature of the clinical expression, HGS is still often undiagnosed both by general practitioners and pediatricians. This lack of diagnosis generally has few consequences due to the benign course in a few days, but the infection can have an important psychological and social leading to significant healthcare costs. Moderate and severe forms require medical care. Aciclovir should be prescribed if the diagnosis is made early (3 days) in combination with symptomatic care. Studies of the medical and economic impact of herpetic gingivostomatis should be conducted.
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PMID:[Herpes simplex in children. Clinical manifestations, diagnostic value of clinical signs, clinical course]. 1212 30

We present 3 sporadic cases of a subacute to chronic, progressive motor (i.e. weakness, ataxia, spasticity, dysarthria, and dysphagia) and cognitive disorder in adults of both sexes, without proven immunocompromise or malignancy. Neuroimaging studies revealed tiny calcifications with atrophy of the cerebrum, pons, and midbrain in 1 patient, cerebral atrophy in another, and cerebral atrophy and periventricular white matter hyperintensities in the third. Clinical diagnoses included cortico-pontine-cerebellar degeneration, mixed neurodegenerative disorder, progressive supranuclear palsy, diffuse Lewy body disease, and Lyme disease. One atrophic brain revealed widely disseminated, millimeter-sized gray lesions in cerebral white matter and obscured anatomic markings of the basis pontis. The most conspicuous microscopic feature in all was capillaries with focally piled up endothelial nuclei, some of which appeared to be multinucleated, or enlarged, hyperchromatic crescentic single nuclei. Although seen mostly without associated damage, they were also noted with white matter lesions displaying vacuolation, demyelination, spheroids, necrosis, vascular fibrosis, and mineralization; these were most severe in the basis pontis. Immunostains and probes to herpes simplex virus-I, -II, and -8; adenovirus, cytomegalovirus, varicella-zoster, Epstein-Barr virus, measles, JC virus, and herpes hominis virus-6 were negative. Electron microscopy revealed no virions in endothelial cells with multilobed or multiple nuclei and duplicated basal laminae. However, mycoplasma-like bodies, mostly 400 to 600 nm in size, were found in endothelial cell cytoplasm and capillary lumina. Platelets adhered to affected endothelial cells. Polymerase chain reaction and immunohistochemistry of fixed samples for Mycoplasma fermentans were negative; other species of Mycoplasma remain viable pathogenic candidates.
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PMID:A novel cerebral microangiopathy with endothelial cell atypia and multifocal white matter lesions: a direct mycoplasmal infection? 2300 Dec 18

Inflammatory pseudotumor (IPT) is a rare benign lesion, often imitating a malignant disease. An IPT was found in the sinus piriformis of a 40-year-old male who suffered from dysphagia, globus feeling and a weight loss of 5 kilograms in six months. Neither common infections previously described in combination with IPT such as human herpes virus (HHV) 8, human immunodeficiency virus (HIV) or acute Epstein Barr virus (EBV), nor evidence of manifestation of a systemic mastocytosis or a malignant disease were found. The primary therapy for IPT in locations other than the orbita is complete resection, if this is not applicable or recurrence occurs then cyclosporine, chlorambucil, indometacin or radiation have been used as alternative treatments. A transoral laser-assisted resection was performed in the case described here, resulting in a complete and lasting cure.
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PMID:Inflammatory pseudotumor of the hypopharynx: clinical diagnosis, immunohistochemical findings and treatment of this rare disease. 1918 Oct 13

Herpes simplex virus is a common cause of ulcerative esophagitis in the immunocompromised or debilitated host. Despite a high prevalence of primary and recurrent Herpes simplex virus infection in the general population, Herpes simplex virus esophagitis (HSVE) appears to be rare in the immunocompetent host. We report three cases of endoscopically-diagnosed HSVE in apparently immunocompetent children; the presentation was characterized by acute onset of fever, odynophagia, and dysphagia. In two cases, the diagnosis was confirmed histologically by identification of herpes viral inclusions and culture of the virus in the presence of inflammation. The third case was considered to have probable HSVE based on the presence of typical cold sore on his lip, typical endoscopic finding, histopathological evidence of inflammation in esophageal biopsies and positive serologic evidence of acute Herpes simplex virus infection. Two cases received an intravenous course of acyclovir and one had self-limited recovery. All three cases had normal immunological workup and excellent health on long-term follow-up.
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PMID:Herpes simplex ulcerative esophagitis in healthy children. 2191 64

Case report. 21 years old woman with 30 week pregnancy, complicated by a 3 month multitreated skin condition, who was referred to General Hospital Morelia, with probable diagnosis of Kapossi sarcoma and sus- pected HIV. She presented with exulcerations involving the palate, lips, chest, abdomen, back and extremities. The lesions were, itchy and painful, with thick yellowish secretion, accompanied by dysphagia to solid foods. Laboratory results showed normochromic normocytic anemia, elevation of ESR, hypocalcaemia, increased PCR, results in alterations in various TORCH listing, HIV negative. The biopsy of a lesion of the forearm reported histological changes consistent with herpes, subsequently confirmed by direct immunofluorescence. Liquid aspiration secretion of one of the lesions reported coagulase negative staphylococcus sp and Enterobacter cloacae. The final diagnosis was 30 weeks pregnant women with gestational herpes complicated by pyogenic infection of the lesions, discarding infection with HIV and found positive for IgG to toxoplasma, rubella, cytomegalovirus and herpes virus.
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PMID:[Herpes gestationis. A case report]. 2551 61

Idiopathic achalasia is an archetype esophageal motor disorder, causing significant impairment of eating ability and reducing quality of life. The pathophysiological underpinnings of this condition are loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter (LES). The clinical manifestations include dysphagia for both solids and liquids, regurgitation of esophageal contents, retrosternal chest pain, cough, aspiration, weight loss and heartburn. Even though idiopathic achalasia was first described more than 300 years ago, researchers are only now beginning to unravel its complex etiology and molecular pathology. The most recent findings indicate an autoimmune component, as suggested by the presence of circulating anti-myenteric plexus autoantibodies, and a genetic predisposition, as suggested by observed correlations with other well-defined genetic syndromes such as Allgrove syndrome and multiple endocrine neoplasia type 2 B syndrome. Viral agents (herpes, varicella zoster) have also been proposed as causative and promoting factors. Unfortunately, the therapeutic approaches available today do not resolve the causes of the disease, and only target the consequential changes to the involved tissues, such as destruction of the LES, rather than restoring or modifying the underlying pathology. New therapies should aim to stop the disease at early stages, thereby preventing the consequential changes from developing and inhibiting permanent damage. This review focuses on the known characteristics of idiopathic achalasia that will help promote understanding its pathogenesis and improve therapeutic management to positively impact the patient's quality of life.
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PMID:New insights into the pathophysiology of achalasia and implications for future treatment. 2767 86

Human cytomegalovirus (CMV) is an infectious herpes virus present in approximately 50% of the world's population. Pharyngitis is an uncommon manifestation of CMV infection, and vocal cord immobility (VCI) following CMV pharyngitis is quite rare. An 83-year-old man with well-controlled diabetes mellitus and hypertension was admitted due to dyspnea, odynophagia, and dysphagia. Laryngeal fiberscopy revealed bilateral vocal cords almost fixed at the median position, with mucosal redness, swelling, and edema at the hypopharyngeal area. The airway was so narrowed that an emergency tracheostomy was performed to secure an airway. VCI resulting from a malignant tumor was suspected at first, but repeated pathological examinations revealed CMV infection in the pharyngeal mucosa. Despite intravenous ganciclovir treatment (5 mg/kg), the patient's bilateral VCI improved only slightly. Laryngeal electromyography was used to investigate the causes of VCI, and revealed vocal fold paralysis on the left side and cricoarytenoid joint fixation on the right side. This case highlights the importance of considering CMV infection in the differential diagnosis of patients with pharyngitis and VCI. To the best of our knowledge, this is the first case report describing the etiology of VCI following CMV pharyngitis using laryngeal electromyography.
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PMID:Bilateral vocal cord immobility resulting from cytomegalovirus pharyngitis: A case report. 2905 57

Cranial polyneuropathy is commonly caused by Lyme disease. We discuss the case of a man who presented with cranial nerve deficits causing dysphagia, dysphonia and facial weakness. This diagnostic dilemma stemmed from a workup that ruled out Lyme and vascular causes leading to an expanded search for infectious explanations, which revealed varicella zoster in the cerebrospinal fluid. On review, this phenomenon is rarely reported, but has been observed with a number of herpes family viruses. In emergency department settings, clinical suspicion should be raised for VZV infection even in the absence of rash in patients that present with multiple cranial nerve palsies.
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PMID:Varicella zoster presenting as cranial polyneuropathy. 3058 17


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