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July 1985

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol. 1985;111(7):486-489. doi:10.1001/archotol.1985.00800090100022


Michael J. Lanser, MD; Harvey Z. Klein, MD; Adam Marvin, MD, San Francisco  A 29-year-old homosexual man had a two-month history of intermittent epistaxis and blood-streaked sputum with ten days of dysphagia, odynophagia, and dysphonia. He had gone to his dentist four months earlier for treatment of gingivitis, at which time an asymptomatic lesion was noted on his hard palate; no biopsy specimen was taken. For the past four months he had also been under the care of a Chinese herbal physician, drinking various teas without improvement. History was notable for a tonsillectomy at the age of 5 years. In recent years he had had multiple infections, including chlamydia, lymphogranuloma venereum, gonorrhea, perianal herpes simplex, amebiasis, and hepatitis A. The patient admitted to multiple illicit drug use, both oral and intravenous. He had used cocaine and amyl nitrates nasally, which resulted in some epistaxis.Examination