A 35-year-old HIV-positive male comes to the physician’s office because of pain on swallowing and substernal burning for the last 3 days. Examination of the oral cavity is unremarkable. Lungs are clear o auscultation and percussion. His current medications include zidovudine, didanosine, indinavir, trimethoprim-sulfamethoxazole, and azithromycin. His last CD4 count is 40cells/microl. What is the most appropriate next step in the management of this patient?
A. Esophagoscopy with biopsy, cytology and culture
B. Oral Fluconazole
C. Oral Famotidine
D. Oral Acyclovir
E. Oral Ganciclovir