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

In a prospective study of 154 AIDS patients, 48 (31%) complained of pain on swallowing both liquids and solids and 32 (21%) of these also had dysphagia. While candidiasis was the most common cause of symptoms (26 patients), discrete ulceration of the oesophagus occurred in 12 instances in 10 patients (four cytomegalovirus, four herpes simplex virus, three aphthous ulcer, one peptic ulcer). One patient had a diffuse oesophagitis caused by Mycobacterium avium intracellulare. No cause was found for the oesophageal symptoms in four patients. Kaposi's sarcoma (KS) was found in seven patients associated with other pathology in four. All 26 patients with oesophageal candidiasis only, also had oral involvement. All the patients with herpes simplex virus (four) and aphthous ulcers (three) had obvious perioral involvement. Three of the four patients with cytomegalovirus ulceration had evidence of disease elsewhere (colon or retina). All patients with Kaposi's sarcoma lesions had skin and buccal cavity involvement. The cause of oesophageal disease was usually obvious at endoscopy. The appearance of candidiasis was typical and the various ulcerating lesions also had different macroscopic configurations. Cytomegalovirus infection produced deep linear ulcers in the distal oesophagus, herpes simplex oesophagitis is similar in appearance to the typical perioral lesions of fluid filled vesicles. Diagnostic radiology was not helpful in most patients. In nine of 17 patients with candidiasis, the barium swallow examination performed within 24 hours of presentation was normal. In only three of seven patients with oesophageal ulceration (three cytomegalovirus, two herpes simplex virus, one aphthous, one peptic) was there evidence of an abnormality. Treatment produces symptomatic relief. All patients with candidiasis responded to ketoconazole, the four with herpes simplex virus to acyclovir and one of three with aphthous ulceration had a dramatic response to thalidomide. The three patients with cytomegalovirus infection who were treated with foscarnet had a prolonged remission of symptoms. The overall prognosis of patients with oesophageal symptoms is poor, with an average survival time from a definitive diagnosis of five months (range one to 13).
 ...
PMID:Oesophageal symptoms, their causes, treatment, and prognosis in patients with the acquired immunodeficiency syndrome. 254 33

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.
 ...
PMID:[Esophagitis caused by Candida albicans]. 268 35

Cineradiography of the esophagus showed signs of esophageal candidiasis in 11 out of 71 patients with progressive systemic sclerosis (PSS) - both in diffuse scleroderma and the CREST syndrome. Culture of esophageal brushings confirmed the presence of Candida albicans in eight of these 11 patients. Antimycotic treatment decreased the cineradiographic signs of candidiasis and the degree of dysphagia. Since impaired esophageal motility and treatment with immunosuppressive drugs may predispose to candida esophagitis, and since dysphagia will decrease after antimycotic treatment esophageal mycosis should always be sought in patients with PSS.
 ...
PMID:Cineradiography identifies esophageal candidiasis in progressive systemic sclerosis. 270 18

Upper gastrointestinal endoscopy was performed for the evaluation of infectious esophagitis in 19 consecutive subjects evaluated prospectively before orthotopic liver transplantation (OLTx), in a separate group of 27 subjects post-OLTx, and in 21 subjects following orthotopic renal transplantation (ORTx). None of the pre-OLTx patients had evidence of infectious esophagitis, whereas 11% of the post-OLTx and 24% of the post-ORTx patients had esophageal infections. Candida esophagitis was found only in the post-ORTx patients, whereas cytomegalovirus and herpes simplex viral esophagitis were found in both the post-ORTx and post-OLTx patients. Dysphagia was associated with evidence of herpes simplex virus infection (P less than 0.001) and epigastric pain was associated with Candida infection (P less than 0.001). No association between the administration of prednisone or the blood level of cyclosporine A and esophagitis was found. Finally, the use of standard low-dose mycostatin prophylaxis was not effective for prevention of Candida esophagitis. Nonetheless the use of higher doses of mycostatin was therapeutic.
 ...
PMID:Infectious esophagitis following liver and renal transplantation. 284 20

Esophageal candidiasis is an opportunistic infection that is being recognized increasingly often in certain patients, including those who have a neoplastic disease, are undergoing protracted antibiotic therapy, or hae acquired immunodeficiency syndrome (AIDS). Impaired cell-mediated immunity may predispose the patient to esophageal mucosal colonization, whereas chemotherapy-induced granulocytopenia may predispose to disseminated candidiasis. Esophageal candidiasis should be suspected in susceptible patients with complaints of substernal odynophagia or dysphagia. The diagnosis is confirmed by endoscopically directed mucosal biopsy. Esophagitis from other causes (eg. herpes simplex virus, cytomegalovirus, or bacterial infection) may develop concomitantly with esophageal candidiasis. Treatment is determined by the clinical and immune status of the patient. Amphotericin B (Fungizone) is administered to immunocompromised patients at risk for disseminated or deeply invasive candidiasis and is indicated in nongranulocytopenic patients whose symptoms prevent reliable administration of oral antifungal agents. Ketoconazole (Nizoral) may be administered to clinically stable nongranulocytopenic patients with esophageal candidiasis limited to the mucosa. Patients with AIDS and a history of esophageal candidiasis usually benefit from long-term suppression with an oral antifungal agent.
 ...
PMID:Esophageal candidiasis. Managing an increasingly prevalent infection. 304 96

Odynophagia and dysphagia are common symptoms of treatable disorders of the esophagus in patients with AIDS. Esophageal candidiasis is the most frequent cause of these symptoms. In patients with AIDS or AIDS-related complex, thrush in combination with odynophagia or dysphagia almost certainly indicates the presence of esophageal candidiasis. Other causes of swallowing disorders in AIDS include opportunistic infection of the esophagus with herpes simplex virus, cytomegalovirus, or, rarely, cryptosporidiosis. Recently, ulcerative esophagitis in AIDS associated with unidentified viral-like particles has been described. Infrequently, Kaposi's sarcoma or lymphoma may involve the posterior pharynx or esophagus, respectively. Because Candida esophagitis is so frequently the cause of odynophagia and/or dysphagia in AIDS, it is suggested that in most cases, a therapeutic trial with an antifungal agent, like ketoconazole, may be appropriate before radiologic or endoscopic examination. Further investigation can be reserved for patients who do not respond to this trial or who have clinical evidence suggesting another esophageal disorder. Herpes simplex and cytomegalovirus esophagitis can be treated with antiviral agents, such as acyclovir and ganciclovir, respectively. Maintenance therapy with antifungal agents to prevent recurrent esophageal candidiasis may be beneficial, but the efficacy and cost effectiveness of this approach remain to be determined. Because of the increasing numbers of patients with AIDS, frequency of esophageal disorders, such as candidiasis, in these patients and the morbidity of these disorders, an expansion of clinical research efforts to determine effective treatment and prophylaxis for these disorders is warranted.
 ...
PMID:Odynophagia/dysphagia in AIDS. 304 65

Oral Candida and Candida esophagitis are common findings in patients with the acquired immune deficiency syndrome. The intestinal protozoan, Cryptosporidium, is known to cause gastrointestinal symptoms in these patients. We report a 2-yr-old child with acquired immune deficiency syndrome, who had oral candidiasis, dysphagia, and vomiting. Upper gastrointestinal endoscopy and esophageal biopsy led to a diagnosis of esophageal cryptosporidiosis. We recommend upper gastrointestinal endoscopy as a diagnostic tool in selected patients with acquired immune deficiency syndrome. This is in contradistinction to a previous report that concludes that endoscopy is not necessary in this setting.
 ...
PMID:Esophageal cryptosporidiosis in a child with acquired immune deficiency syndrome. 375 22

We studied the gastrointestinal manifestations in 26 cases of AIDS. The patients belonged to two different epidemiological groups: the first group included thirteen french homosexual men, the second group included 6 Haitians, 6 Africans and a Pakistanian, none of them admit homosexual activity. The clinical manifestations were: chronic watery diarrhea in 17 cases, bloody diarrhea in 2 cases; loss of weight in the 26 cases; dysphagia in five cases; jaundice in one patient (due to Kaposi sarcoma of the ampulla of Vater). The digestive lesions found, alone or associated, were necrotizing enteritis (2), ulcerative colitis (1), pseudomembranous colitis (1), Candida esophagitis (10), erythematous duodenitis (6), proctitis (4), Kaposi sarcoma (3), diffuse (2) or localized (1). Thirteen patients out of the 26 presented opportunistic digestive infections due to one or several germs. These were 10 cases of esophageal infection (due to Candida albicans) and 8 cases of enterocolonic infection due to Cytomegalovirus (3 cases), Cryptosporidium (3 cases), Mycobacterium avium intracellulare (1 case), Cryptococcus neoformans (1 case). The other digestive infections cases were due to non-opportunistic pathogens: Entamoeba histolytica (3 cases); Giardia lamblia (3 cases); Strongyloides stercoralis (2 cases); Salmonella typhi (2 cases); Shigella (1 case); Herpes simplex virus (1 case). No difference was noticed between the homosexual and the heterosexual groups with respect to the nature and the frequency of the digestive infections.
 ...
PMID:[Digestive manifestations of the acquired immunodeficiency syndrome (AIDS): study in 26 patients]. 399 15

Severe oesophageal candidiasis and croup due to involvement of the larynx developed insidiously in a girl aged 20 months. There had been delayed separation of the umbilical cord and repeated infections associated with a defect of neutrophil motility. The significance of the early clinical features was not fully appreciated and the diagnosis considered only when stricture of the oesophagus became evident. She was treated with oral ketoconazole 100 mg daily. After one month's treatment there was striking radiological improvement apart from the persistence of the oesophageal stricture. The croup resolved completely but there was only partial relief of dysphagia because of the residual stricture. We would emphasis that candidiasis should be anticipated and treated vigorously in children with such a defect of neutrophil motility.
 ...
PMID:Oesophageal candidiasis and croup in a child with defective neutrophil motility. 633 Feb 10

Candida esophagitis is being increasingly recognized in the practice of clinical gastroenterology. The widespread use of corticosteroids, immunosuppressive drugs, and cancer chemotherapy, combined with the frequent use of endoscopy for the evaluation of esophageal symptoms, often leads to the identification of Candida infection in this part of the gastrointestinal tract. The salient clinical features of Candida esophagitis include odynophagia and dysphagia, although gastrointestinal bleeding may occasionally be the sole presenting symptom. While the radiological signs of Candida esophagitis are nonspecific, the endoscopic appearance is quite characteristic. Demonstration of tissue invasion by fungal mycelia on mucosal biopsy of the esophagus is diagnostic. The role of serology in the diagnosis of Candida esophagitis is not well defined. Oral nystatin therapy has been extensively used to control Candida infection of the esophagus. More recently amphotericin-B, 5-fluorocytosine and imidazole derivatives have been effectively used to treat recalcitrant cases of Candida esophagitis.
 ...
PMID:Candida esophagitis. 633 83


<< Previous 1 2 3 4 5 6 7 8 Next >>