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Acute primary HIV-esophagitis.
J F Bartelsman1, J M Lange, R van Leeuwen
1Department of Gastroenterology, Academic Medical Center, University of Amsterdam.
Endoscopy
|July 1, 1990
Summary
Acute primary Human Immunodeficiency Virus (HIV)-esophagitis presents with fever, diarrhea, and odynophagia. Early HIV detection is crucial for timely intervention in patients with esophageal symptoms.
Area of Science:
- Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Acute primary Human Immunodeficiency Virus (HIV) infection can manifest with diverse clinical symptoms.
- Esophageal involvement during primary HIV infection, known as HIV-esophagitis, is a recognized but less common presentation.
Observation:
- A 29-year-old male presented with acute symptoms including fever, diarrhea, odynophagia (painful swallowing), and a skin rash.
- Esophageal endoscopy revealed multiple small, shallow ulcerations, indicative of esophagitis.
- Diagnostic markers for HIV were detected sequentially: HIV-1 p24 antigen was identified in blood 7 days after symptom onset, while seroconversion for HIV-1 antibodies occurred 2 days after onset.
Findings:
- The case highlights acute primary HIV-esophagitis as a cause of odynophagia and esophageal ulcerations.
- The diagnostic window for detecting HIV-1 p24 antigen and antibodies during acute infection can vary.
- Early recognition of HIV-esophagitis is important for initiating prompt antiretroviral therapy.
Implications:
- This case underscores the importance of considering primary HIV infection in the differential diagnosis of unexplained esophagitis, especially in individuals with risk factors.
- Timely diagnosis and initiation of treatment for HIV infection can prevent disease progression and opportunistic infections.
- Further research into the spectrum and diagnostic challenges of primary HIV infection manifestations is warranted.