Laine L, Bonacini M
Department of Medicine, University of Southern California School of Medicine, Los Angeles.
Arch Intern Med. 1994 Jul 25;154(14):1577-82.
Up to 40% of patients with the acquired immunodeficiency syndrome may develop symptoms of esophageal disease. Candida esophagitis is responsible for the majority of the cases of esophageal disease; cytomegalovirus, herpes simplex, idiopathic esophageal ulcers, and Kaposi's sarcoma account for most of the remaining cases. Although endoscopy with esophageal biopsy and brushing is the gold standard for the diagnosis of esophageal disease in the acquired immunodeficiency syndrome, we generally recommend initial empiric therapy with an antifungal agent in patients with esophageal symptoms. Since effective treatment is available for most cases of esophageal disease in the acquired immunodeficiency syndrome, we recommend endoscopic evaluation in patients who do not respond to empiric therapy within 1 to 2 weeks.
高达40%的获得性免疫缺陷综合征患者可能会出现食管疾病症状。念珠菌食管炎是大多数食管疾病病例的病因；巨细胞病毒、单纯疱疹、特发性食管溃疡和卡波西肉瘤占其余大多数病例。虽然食管活检和刷检的内镜检查是诊断获得性免疫缺陷综合征食管疾病的金标准，但我们通常建议对有食管症状的患者首先使用抗真菌药物进行经验性治疗。由于获得性免疫缺陷综合征中大多数食管疾病病例都有有效的治疗方法，我们建议对在1至2周内对经验性治疗无反应的患者进行内镜评估。
