Esophageal ulcer caused by cytomegalovirus: Resolution during combination antiretroviral therapy for acquired immunodeficiency syndrome

Citation
Ke. Monkemuller et Cm. Wilcox, Esophageal ulcer caused by cytomegalovirus: Resolution during combination antiretroviral therapy for acquired immunodeficiency syndrome, SOUTH MED J, 93(8), 2000, pp. 818-820
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
SOUTHERN MEDICAL JOURNAL
ISSN journal
0038-4348 → ACNP
Volume
93
Issue
8
Year of publication
2000
Pages
818 - 820
Database
ISI
SICI code
0038-4348(200008)93:8<818:EUCBCR>2.0.ZU;2-B
Abstract
A 36-year-old man with a 5-year history of untreated human immunodeficiency virus (HIV) infection had odynophagia for 14 days. Fifteen days earlier, h e had begun taking trimethoprim-sulphamethoxazole and combination antiretro viral therapy that included lamivudine, zidovudine, and nelfinavir. He had no history of opportunistic infection. The CD4 lymphocyte count was 67/mu L and HIV-RNA level was 359,396 copies/mL. Esophagogastroduodenoscopy reveal ed a large, well-circumscribed esophageal ulceration 31 cm from the incisor s. Histopathologic examination of esophageal biopsy specimens showed cytopa thic changes diagnostic of cytomegalovirus (CMV). In situ DNA hybridization was positive for CMV. While combination antiretroviral therapy was continu ed, the esophageal symptoms resolved within 4 days of endoscopy without spe cific therapy for CMV. Follow-up endoscopy 4 weeks later revealed a normal- appearing esophagus, and the patient has remained symptom-free for 10 month s.