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Esophageal ulcers in AIDS

E E Calore1, J M Cavaliere, N M Perez

  • 1Instituto de Infectologia Emílio Ribas, Seção de Anatomia Patológica, São Paulo, Brazil.

Pathologica
|April 1, 1997
PubMed
Summary

Infections in AIDS patients are common, with Acid-Fast bacilli found in esophageal biopsies. This suggests Mycobacterium sp. esophageal ulcers may be overlooked and warrants routine screening for tuberculosis in AIDS patients.

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Area of Science:

  • Medical Microbiology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Esophagitis is a common complication in patients with Acquired Immunodeficiency Syndrome (AIDS).
  • Identifying the causative infectious agents is crucial for effective management.
  • Previous reports may underestimate the prevalence of certain opportunistic infections in the esophagus of AIDS patients.

Purpose of the Study:

  • To investigate the prevalence and types of infectious agents in esophageal biopsies from AIDS patients with esophagitis.
  • To highlight the potential underdiagnosis of Mycobacterium sp. as a cause of esophageal ulcers in this population.

Main Methods:

  • Retrospective review of 35 esophageal biopsies from AIDS patients presenting with esophagitis over a two-year period.
  • Microscopic examination of biopsies to identify microorganisms and inflammatory patterns.
  • Histopathological analysis to detect Acid-Fast bacilli, cytomegalic inclusions, and Candida.

Main Results:

  • Microorganisms were identified in 48.6% of biopsies.
  • Acid-Fast bacilli (Mycobacterium sp.) were found in 17.1% of cases, with some co-infection by cytomegalovirus.
  • Cytomegalovirus and candidiasis were each detected in 14.3% of cases, with one case showing co-infection.

Conclusions:

  • Esophageal ulcers caused by Mycobacterium sp. may be more common in AIDS patients than previously recognized.
  • Esophageal biopsy is a valuable and accessible diagnostic tool for screening tuberculosis in AIDS patients.
  • Routine screening for mycobacterial esophagitis should be considered in AIDS patients with esophageal symptoms.

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