Cases reported "Esophagitis"

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1/226. Surgical management of necrotizing candida esophagitis.

    Invasive esophageal candidiasis produced transmural necrosis leading to perforation in 2 patients aged 10 and 27 years. Both patients survived after esophageal resection and complete diversion. One patient with acute leukemia and neutropenia experienced systemic candidiasis, which resolved after esophagectomy. esophagectomy and diversion for yeast-induced necrosis may lead to complete recovery and resolution of disseminated candidiasis when combined with systemic antifungal therapy.
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2/226. esophagitis dissecans superficialis associated with pemphigus vulgaris.

    The extension of bullous lesions in pemphigus to the esophagus is relatively uncommon, especially in patients who appear to be in clinical remission. Very rarely, pemphigus vulgaris may affect the entire esophagus, resulting in complete sloughing of the mucous membrane. A 20-year-old man with pemphigus vulgaris presented to the emergency room with acute onset of dysphagia, odynophagia, and hemoptysis. There were no cutaneous or oral findings of pemphigus on presentation, since he was being maintained on corticosteroids and azathioprine with excellent results. During initial evaluation in the emergency room, the patient was observed to vomit a cast of the mucosal lining of the esophagus. The morphologic description of such an esophageal cast is termed esophagitis dissecans superficialis. This is the third case of esophagitis dissecans superficialis in pemphigus vulgaris recorded in the medical literature.
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3/226. Tuberculous esophagitis.

    Roentgenographic changes in a case of tuberculosis involving the esophagus were ulceration and narrowing of the esophagus, and sinus tracts to the mediastinum. Disseminated tuberculosis was discovered only at autopsy. The diagnosis of tuberculous esophagitis in a patient with no other demonstrable tuberculous lesions is difficult, as clinical and roentgenographic findings are not specific.
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4/226. An unusual complication of subclavian vein catheterization for total parenteral nutrition.

    A 25-year-old woman with diabetic ketoacidosis and esophagitis was given total parenteral nutrition to improve her nutritional status. A central venous catheter inserted in the right subclavian vein was well tolerated for three weeks, when infection developed. The line was replaced by a left subclavian line. Within an hour the patient complained of back pain. A chest x-ray film showed that the tip of the catheter was to the left of the mediastinum and that left pleural effusion was present. The line was removed and 1,500 cc of fluid was removed from the left pleural space. The pleural fluid cleared gradually over several days and the patient became asymptomatic.
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5/226. Gastroesophageal involvement in herpes simplex.

    herpes simplex in the gastric mucosa has not been previously described. The case presented here describes gastritis and esophagitis resulting from herpes simplex in a patient being treated with immunosuppressive agents. These changes were confirmed endoscopically and radiographically. biopsy specimens of the gastric and esophageal mucosa showed eosinophilic intranuclear inclusion bodies typical of herpes simplex. The pathogenesis and pathological appearance of herpetic gastritis and esophagitis are presented.
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6/226. esophagitis induced by combined radiation and adriamycin.

    With the increasing use of combined chemotherapy and radiotherapy in the treatment of certain types of malignancy, a clinically distinct type of esophagitis has been recognized as an undesirable side effect. It occurs with low doses (less than 2,000 rad) of mediastinal radiation in patients who simultaneously or sequentially receive either adriamycin or actinomycin D. Characteristic of this entity is "recall": recurrent episodes of esophagitis with each course of chemotherapy. The radiographic findings are nonspecific, ranging from subtle alterations in motility to severe damage with irreversible stricture formation. The primary differential diagnostic considerations are infectious processes. The radiographic spectrum, clinical aspects, and differential diagnoses in five patients are discussed.
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7/226. Orbital Kaposi's sarcoma in acquired immunodeficiency syndrome.

    A 28-year-old white male with AIDS-C3 staging, presented with an extensive hemorrhagic dark mass localized in the left orbit. No other ophthalmic findings were disclosed. ultrasonography and computed axial tomographic scans showed orbital involvement. Orbital Kaposi's sarcoma is a rare finding and only a few cases have been reported. Systemic examination revealed other lesions suggestive of disseminated mucocutaneous Kaposi's sarcoma, oral candidiasis, membranous esophagitis and granulomatous hepatitis. Eyelid incisional biopsy disclosed Kaposi's sarcoma. Despite intensive chemotherapy progression was aggressive with a fatal outcome.
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8/226. diabetes insipidus in a patient with a highly malignant B-cell lymphoma and stomatitis.

    A 37-year-old male patient with a diffuse pleomorphic B-cell-lymphoma, which has been diagnosed two month earlier with the primary site at the pterygopalatine fossa on both sides with infiltration of the clivus and cavernous sinus was referred to our hospital for continuation of the third course of CHOP chemotherapy. At admission he reported about a recent history of painful swallowing and intermittent substernal chest pain. Alleviation of the pain on swallowing and the chest pain was apparently only possible by drinking 10 to 15 l of cold coca cola throughout the day and night, a regimen that resulted in polyuria. physical examination revealed extensive thrush stomatitis and soor esophagitis. Despite successful treatment with fluconazole, polydipsia continued unabated. The classic osmotic test of dehydration and exogenous vasopressin revealed hypothalamic diabetes insipidus (DI). Basal hormones and stimulated endocrine function tests of the adenohypophysis were found to be normal. MRI-scan revealed lymphoma infiltration of the neurohypophysis. After the third course of CHOP chemotherapy the patient surprisingly recovered completely from his excessive thirst. The present report shows that clinical disorders such as thrush stomatitis can mask diabetes insipidus caused by an early relapsing lymphoma.
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9/226. doxycycline-induced esophageal ulceration in the U.S. Military service.

    U.S. military forces are frequently deployed with little warning to regions of the world where chloroquine-resistant malaria is endemic. doxycycline is often used for malaria chemoprophylaxis in these environments. The use of doxycycline can be complicated by esophageal injury. Two cases of esophageal ulceration will be discussed, followed by a review of the literature. doxycycline causes esophageal injury through a combination of drug-specific factors, the circumstances of drug administration, and individual patient conditions. patients with dysphagia attributable to esophageal ulceration are managed by intravenous fluid support and control of gastric acid reflux until their symptoms resolve over 5 to 7 days. The risk of esophageal injury can be minimized by use of fresh capsules, drug administration in the upright position well before lying down to sleep, and drinking at least 100 ml of water after swallowing the medication.
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keywords = reflux
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10/226. Esophageal candidoma in a patient with acquired immunodeficiency syndrome.

    Oral thrush and esophagitis caused by candida are common in patients infected with the human immunodeficiency virus. We present the case of a 33-year-old man with acquired immunodeficiency syndrome who developed dysphagia during a hospitalization for pneumonia. signs and symptoms were consistent with candida esophagitis. Despite therapy with fluconazole, the patient's symptoms persisted. At upper endoscopy, a 1-cm, polypoid esophageal mass at 30 cm from the incisors and several other nodular lesions were observed; white plaques were noted throughout the esophagus. biopsy specimens of the mass contained hyphal forms consistent with candida species. Therapy with amphotericin b improved the patient's symptoms, and resolution of the mass was confirmed by repeat upper endoscopy. We believe this is the first case in the medical literature of a candida mass (candidoma) causing dysphagia in a patient with acquired immunodeficiency syndrome. Candidoma should be considered in the differential diagnosis of dysphagia in patients with human immunodeficiency virus infection or immunosuppression due to other causes.
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