Intake presentation on candidal esophagitis

2022-03-25

cc: trouble swallowing and weight loss

28M w few weeks of trouble swallowing (gets stuck “right here,” points to mid-sternum), solid/liquids same, gradual over months-weeks, some vomiting w/o specific timing. Sometimes has pain when not eating. 20lb weight loss over months. No skin lesions. ?thrush.

PMHx/PSHx

dx BPD, no other dx or procedures

SHx

• MSM w occasional use of protection, no PrEP
• occ MJ use, no other substances
• unemployed, lives w mom
• no unusual hobbies or travel

PE

HR 100, SBP 80 -> 100 w 500mL LR, AF cachectic (temporal, hypothenar wasting) +skin tenting diffuse abd tenderness

w/u

Hgb 10, MCV 88, WBC ~4, ANC 1500 BMP wnl Alb 3.4 HIV+, VL 15k, rest of STI -ve

CXR wnl (AP and lateral)

dx

candidal esophagitis, achalasia, H Pylori PUD