Odynophagia and dysphagia in HIV

Background

Etiology

• Candida, by far the most common
• Herpes simplex virus
• Cytomegalovirus
• Aphthous ulcers

Management

• Often treated empirically as Candida, followed by upper endoscopy if no improvement within 5 to 7 days
  • Fluconazole 200 mg PO once followed by 100 to 200 mg PO daily
• Patients with more prominent odynophagia are more likely to have a non-candidal cause