Idiopathic midesophageal stricture: a new cause of dysphagia in a patient with AIDS.

A number of disorders may result in the complaint of dysphagia in HIV-infected patients. These include fungal, viral, bacterial, parasitic, medication-induced, and idiopathic lesions in the esophagus. In the current case, a 32-year-old man with advanced HIV infection had recurrent bouts of esophageal stricture. No ulcer was associated with this stricture. No infectious causes of the stricture could be determined. The patient required multiple upper endoscopies and dilatations for treatment of this stricture and subsequently had a food impaction. This is the first case in the medical literature of an idiopathic stricture in the middle portion of the esophagus in an HIV-infected patient. We postulate that this lesion may have been caused by the patient's medications. Esophageal strictures should be considered in HIV-infected patients with severe dysphagia or food-bolus impactions of the esophagus.