Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An enameler with dysphagia was found to have extrinsic compression of the esophagus by enlarged mediastinal lymph nodes. Scalene lymph node biopsy revealed silicosis, and tissue cultures grew Mycobacterium intracellulare. We believe our patient is the first reported to have dysphagia due to silicotic adenopathy complicated by an atypical mycobacteriosis.
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PMID:Esophageal compression in association with silicosis and Mycobacterium intracellulare. 51 11

This report describes a patient with a 2-wk history of epigastric pain and dysphagia, and a mid-esophageal ulceration resulting from infection with Mycobacterium tuberculosis. This is an uncommon site of tuberculous involvement, and usually results from direct extension from adjacent mediastinal or hilar lymph nodes, reactivated lung infection, infected vertebral bodies or aortic aneurysms, or from extension from the pharynx or larynx. The endoscopic lesion is ulcerative, with shallow, smooth edges, granular, with small mucosal miliary granulomas, or hyperplastic, with fibrosis, luminal narrowing, and stricture formation. The patient responded well to antituberculous therapy, and is healthy 4 yr after therapy.
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PMID:Esophageal tuberculosis: definitive diagnosis by endoscopy. 222 Jul 49

A patient with acquired immune deficiency syndrome (AIDS) who presented with dysphagia is described. Barium swallow demonstrated diffuse esophagitis with longitudinal ulceration and sinus tracts to the mediastinum. Mycobacteria were seen on esophageal biopsies and Mycobacterium tuberculosis was cultured from a pleural effusion. Mycobacterial esophagitis should be considered in the differential diagnosis of esophagitis in AIDS, particularly when sinus tracts are demonstrated.
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PMID:Mycobacterial esophagitis in AIDS. 249 1

Eighty-five patients with the acquired immunodeficiency syndrome (AIDS) were treated at Fairfield Infectious Diseases Hospital between April 1984 and June 1987. Sixty per cent of patients suffered gastrointestinal symptoms during the period of study, and in a further 15% of patients, abnormalities of the gastrointestinal tract were found incidentally. The principal manifestations were oropharyngeal ulceration, dysphagia/odynophagia, abdominal pain, diarrhoea, gastrointestinal bleeding, and perianal lesions. Opportunistic diseases involving all parts of the gastrointestinal system were encountered, the most prevalent being infections that were caused by Candida spp., cytomegalovirus, Mycobacterium avium-intracellulare and herpes simplex, and Kaposi's sarcoma. Abnormal liver-function test-results were found in 41 patients; most commonly, these were attributable to minor drug reactions, and cytomegalovirus or Myco. avium-intracellulare infection. Only one patient became jaundiced clinically. We conclude that involvement of the gastrointestinal tract is common in patients with AIDS, and that gastrointestinal lesions are an important cause of morbidity and mortality in these patients.
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PMID:The gastrointestinal and hepatic manifestations of the acquired immunodeficiency syndrome. 271 83

There are increasing challenges for the practising gastroenterologist in treating AIDS-related gastrointestinal diseases. The differential diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, non-specific aphthous ulceration and non-AIDS oesophageal diseases, especially reflux oesophagitis. Chronic subacute abdominal pain with nausea, vomiting, early satiety and weight loss is suggestive of an obstructive lesion caused by lymphoma or Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis or intestinal perforation due to cytomegalovirus. Right upper quadrant pain (with or without fever, vomiting or abnormal liver function tests with a cholestatic profile) is suggestive of hepatobiliary pathology including cholecystitis, cholangitis, acalculous cholecystitis and AIDS cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare, Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni), and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition and weight loss can shorten the life-span of patients with AIDS. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting.
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PMID:AIDS and the gut. 805 32

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

Gastrointestinal (GI) symptoms are part of the most frequent complaints in HIV disease. A methodical effort is required to identify treatable syndromes. Progressive immunodeficiency is associated with increased prevalence of opportunistic or non-opportunistic infections and neoplasms. Dysphagia and odynophagia, in the majority due to candida esophagitis, are best evaluated by endoscopy. In the presence of diarrhea, upper GI endoscopy is indicated if evaluations of stool and endoscopy of the lower GI tract are negative and may uncover proximal small-bowel infection by Cryptosporidium, Microsporidium or Mycobacterium avium. HIV-associated neoplasias (Kaposi's sarcoma, non-Hodgkin lymphomas), not rarely affecting the upper GI tract and sometimes leading to obstruction or bleeding, are reliably diagnosed only by endoscopy. Since visible lesions mostly are nonspecific and normal-appearing mucosa may harbor pathogens, biopsies for pathology and cultures are crucial for correct diagnosis in GI diseases of HIV-infected patients.
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PMID:[Endoscopy of the upper gastrointestinal tract in HIV disease]. 865 96

A prospective study on the microbes isolated from the alimentary tract in 120 bone marrow transplant (BMT) recipients (1991-1993) was undertaken to define the spectrum of organisms isolated under antimicrobial prophylaxis, their temporal sequence of emergence, and the associated morbidity and mortality. Clostridium difficile (n = 20), isolated in the pre-engraftment and early post-engraftment periods (day 2-45 post-BMT), was the most common microbe recovered from stool of patients with diarrhea. In contrast to previous reports, no significant difference in mortality was observed between patients with and without C. difficile isolated in stool. Two patients had neutropenic ileocecitis with concomitant bacteremia due to Escherichia coli and Klebsiella pneumoniae. One patient was found to have astrovirus gastroenteritis (day 7), and Giardia lamblia was recovered from the stool of another (day -7). Heavy growth of Staphylococcus aureus from direct smear-positive specimens was found from the upper airway of two patients with severe mucositis and complete dysphagia (day 12 and 23). Salmonella spp. of groups B and E were found in the stool of five asymptomatic patients at the time of conditioning. No specific organisms was recovered from the endoscopic brushing of two patients with lower end esophagitis, three patients with upper gastrointestinal bleeding, and three patients with perirectal cellulitis. During the post-engraftment period, five patients had documented cytomegalovirus gastroenterocolitis (days 34-97), one had Mycobacterium chelonae colitis (day 70), and another had nodular gastritis due to Acremonium falciforme (day 270). Overall, only 28% of patients with alimentary tract symptoms/syndrome had specific pathogens isolated from clinical specimens. Differentiation of the causation of alimentary tract symptoms was often difficult because noninfectious complications such as conditioning toxicity, graft-versus-host disease, and its treatment often caused alimentary tract symptoms in addition to predisposed BMT patient to infection. The reluctance of obtaining tissue biopsy for ascertaining the importance of those potential alimentary tract pathogens often dictate the use of empirical treatment.
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PMID:Clinical significance of alimentary tract microbes in bone marrow transplant recipients. 955 72

Laryngeal tuberculosis, although the most common granulomatous disease of the larynx, is a rare form of extrapulmonary tuberculosis, never reported in immunosuppressed allograft recipients. We present two cases of laryngeal tuberculosis in renal transplant patients and a review of the literature. Two women, a 29-year-old and a 60-year-old, each more than 9 years after their cadaveric renal allograft, presented with a 2-week febrile illness with hoarseness and dysphagia, and both were found to have laryngeal tuberculosis by direct laryngoscopy. Although both radiographs were unremarkable, both patients had sputum positive for acid-fast bacilli that subsequently grew Mycobacterium tuberculosis. Clinical response promptly followed institution of isoniazid, rifampicin, and pyrazinamide in each case, although both required threefold increases in daily cyclosporin A dosage to maintain therapeutic levels.
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PMID:Laryngeal tuberculosis in renal allograft patients. 958 Jan 43

Two patients with an HIV-I infection, a man aged 47 with confusion, aphasia and diarrhoea, and a man aged 32 with dysphagia, a non-productive cough and diarrhoea, were diagnosed as having a disseminated Mycobacterium genavense infection. Both had low counts of CD4+ T lymphocytes. They responded to antimycobacterial treatment. M. genavense was recognized in Geneva in the early nineties as a causative agent of disseminated mycobacterial infections in HIV-seropositive patients with poor cellular immunity. The clinical picture resembles that of a generalized infection with M. avium-intracellulare. M. genavense is a slowly growing mycobacterium which can be isolated and identified using enriched nutrient media and molecular-biological techniques. The infection probably begins in the gastrointestinal tract after oral contamination. DNA of M. genavense can be demonstrated in 25% of the intestinal biopsy samples of non-HIV-seropositive patients.
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PMID:[Mycobacterium genavense infection in 2 HIV seropositive patients in Amsterdam]. 1002 45


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