J Korean Soc Radiol.  2014 Mar;70(3):209-212. 10.3348/jksr.2014.70.3.209.

Esophago-Pleural Fistula with Multiple Esophageal Ulcers in Human Immunodeficiency Virus Infected Patient: A Case Report

Affiliations
  • 1Department of Radiology, Seoul Medical Center, Seoul, Korea. ykradio@medimail.co.kr
  • 2Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.
  • 3Department of Thoracic and Cardiovascular Surgery, Seoul Medical Center, Seoul, Korea.

Abstract

Esophagitis is a common complication in patients with human immunodeficiency virus (HIV) infection. Esophagitis in HIV infected patient is caused by candidiasis, cytomegalovirus, herpes simplex virus, or idiopathic esophagitis with no detectable etiology. Esophagitis in HIV infected patient is occasionally combined with esophageal ulcers. We report chest CT findings and clinical manifestation of esophago-pleural fistula with pneumothorax in a HIV infected patient, who was treated for aspiration pneumonia and esophageal ulcers.


MeSH Terms

Candidiasis
Cytomegalovirus
Esophagitis
Fistula*
HIV*
Humans*
Pneumonia, Aspiration
Pneumothorax
Simplexvirus
Tomography, X-Ray Computed
Ulcer*

Figure

  • Fig. 1 A 29-year-old HIV infected man with esophago-pleural fistula. A. A non-enhanced low dose chest CT scan shows multiple ill-defined centrilobular nodules and bronchial wall thickening in left lower lobe. B, C. A non-enhanced low dose chest CT scan shows upper esophageal wall thickening with luminal irregularity (arrow). D. A non-enhanced low dose chest CT scan with lung setting shows pneumomediastinum around upper esophagus (black arrowhead). E. An esophagogastroduodenoscophy shows deep esophageal ulcer (arrow) and diffuse desquamation of mucosa. F. A chest radiography (anteroposterior view) shows right hydropneumothorax (asterisk). G, H. A contrast-enhanced CT scan shows esophago-pleural fistula (arrow) between upper esophagus and right pleural space. Multiple air bubbles are presented in dependent portion of right pleural effusion.


Reference

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