Acute HIV Infection Presenting With Painful Swallowing and Esophageal Ulcers

Linda Rabeneck, Mikulas Popovic, Suzanne Gartner, Donald M. McLean, W. Alastair McLeod, Elizabeth Read, Kathleen K. Wong, William J. Boyko

Research output: Contribution to journalArticlepeer-review


We describe an acute human immunodeficiency virus (HIV) infection in 16 homosexual men who presented with painful swallowing (odynophagia). Eleven men had a maculopapular rash and 3 had palatal ulcers. At esophagogastroduodenoscopy (endoscopy), multiple discrete esophageal ulcers measuring 0.3 to 1.5 cm in diameter were observed. Electron microscopy of biopsy specimens taken from the ulcer margins in 8 men revealed viral particles 120 to 160 nm in diameter whose morphologic characteristics were those of retroviruses. Human immunodeficiency virus seroconversion was documented in 15 men by Western blot analysis. In 3 men, HIV-1 was isolated from peripheral blood mononuclear cells, in 2 men HIV-1 was isolated from peripheral blood monocytes, and in 1 man HIV-1 was isolated from tissue taken from the margins of the esophageal ulcers. These observations extend our knowledge of the clinical spectrum of acute HIV infection syndromes and suggest that cells in the esophagus are a target for HIV-1 infection.

Original languageEnglish (US)
Pages (from-to)2318-2322
Number of pages5
JournalJournal of the American Medical Association
Issue number17
StatePublished - May 2 1990
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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