A 40-year-old immunocompromised man with HIV presents with painful swallowing and food impaction. Barium swallow shows multiple small, linear, plaque-like filling defects aligned longitudinally along the esophageal wall, producing a 'shaggy' or 'cobblestone' appearance of the mucosa. This is most characteristic of:

• A Candida esophagitis ✓
• B Herpes esophagitis
• C Reflux esophagitis
• D Eosinophilic esophagitis

Explanation

Candida esophagitis in immunocompromised patients shows multiple small, linear, longitudinally oriented plaques producing a 'shaggy' or 'cobblestone' appearance. Herpes causes multiple small discrete ulcers on normal background mucosa. Reflux esophagitis shows granular or ulcerated mucosa in the distal esophagus. Eosinophilic esophagitis shows concentric rings (feline esophagus) and small-caliber esophagus.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.