18th July 2023

You see a 65-year-old woman in a gastroenterology clinic with a long-standing history of dysphagia

You see a 65-year-old woman in a gastroenterology clinic with a long-standing history of dysphagia to solids and liquids and regurgitation after eating. She grew up in rural Bolivia and is currently visiting her daughter who now lives in the UK. A chest X-ray is performed, which shows a markedly dilated mediastinum with an air-fluid level. A CT scan of the abdomen revealed a grossly dilated oesophagus that narrowed at the level of gastro-oesophageal junction.

What type of pathogen is most likely responsible for this woman’s symptoms?

Select the SINGLE most appropriate option from the list below. Select ONE option only.