Facco M, Brun P, Baesso I, et al. A 25-year-old lady presented to the Emergency Department with a history of fever and painful oral ulcers of 4 days’ duration. ** This randomized, double-blind study demonstrates the efficacy of caspofungin with fluconazole; however, there is a lack of azole-resistant Candida spp treated. Herpes simplex virus (HSV) has been associated with PV lesions of the oral mucosa, though a clear-cut relationship between these 2 entities has yet to be established.5 Herpes simplex virus has likewise been confirmed in therapy-resistant exacerbations of PV.6 Herpes esophagitis is a rare consequence of treatment with prednisone and MMF that is primarily encountered in patients with a history of solid organ transplantation7 and rarely has been reported in PV patients undergoing therapeutic immunosuppression. The rupture was confirmed in the operating room, and corrected with two sutures and two chest tubes. Early recognition of this complication of Herpes Zoster is very important, because timely diagnosis can result in preferable outcome with conservative treatment only avoiding unnecessary surgical intervention. This paper reviews these reported cases in detail along with newer diagnostic and treatment options, including direction of future therapy.
Although achalasia cannot be permanently cured, excellent outcomes are achieved in over 90 % of patients. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting. Endoscopically, extensive involvement was common, showing friable mucosa (84.2%), numerous ulcers (86.8%), and whitish-exudates (39.5%). Herpes simplex virus type 1 (HSV-1) was identified in 27 cases and herpes simplex virus type 2 (HSV-2) only in 1 case. According to radiotherapy in patients with medical history and symptoms, diagnosis is not difficult, there are early symptoms, Barium swallow examination showed full peristaltic waves weaken, esophageal ulcers, late is visible esophageal stricture, esophageal endoscopy esophagitis can get a glimpse of different periods. Endoscopy revealed gastritis and esophagitis with mucosal tears. The outcome was favorable in all cases, although an esophageal perforation occurred in 1 patient.
In our patient, the biopsy specimens revealed whorls of spindle-shaped cells and neovascularization with small-vessel proliferation suggestive of Kaposi sarcoma. Because of the unknown pathogenesis of achalasia, a healing treatment is not available nowadays.