[A giant esophageal ulcer in a hemophiliac with HIV infection]

A 21-year-old man with hemophilia B and human immunodeficiency virus (HIV) infection was admitted with hematemesis and melena. After admission, esophagogram and endoscopy showed a single giant ulcer with ovoid shape and slightly irregular margins in the middle esophagus. Biopsy specimens of the esophageal ulcer showed non-specific granulation and etiology was unknown. Therapeutic trails of famotidine, sodium alginate, acyclovir, and amphotericin B did not result in favorable response. With a combination therapy of dexamethasone and sucralfate, the swallowing pain was rapidly disappeared with gradual improvement of the ulcer. To our knowledge, this is the first report of a giant esophageal ulcer in a HIV infected patient in Japan.