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Esophagitis - infectious


Definition:

Esophagitis is a general term for any inflammation, irritation, or swelling of the esophagus -- the tube that leads from the back of the mouth to the stomach.

Infection in the esophagus may be due to:

  • Fungi or yeast (most often Candida)
  • Viruses, such as herpes or cytomegalovirus
Causes:

Infection of the esophagus is rare in people whose immune system works well.

A weakened immune system raises your risk for this type of infection, and makes it harder to treat.

Common causes include:

  • HIV /AIDS
  • Chemotherapy
  • Diabetes
  • Leukemia or lymphoma
  • Organ transplants (due to drugs that suppress the immune system)
  • Other conditions that suppress or weaken your immune system
Symptoms:

Symptoms include:

  • Difficulty swallowing and painful swallowing
  • Fever and chills
  • Oral thrush (with candida)
  • Sores in the mouth or back of the throat (with herpes or cytomegalovirus)
Exams and Tests:
  • Blood and urine tests for cytomegalovirus (CMV)
  • Culture of cells from the esophagus for herpes or CMV
  • Mouth or throat swab culture for candida
Treatment:

In most people with esophagitis, medicines can control the infection:

  • Antiviral medication such as acyclovir, famciclovir, or valacyclovir can treat a herpes infection.
  • Antifungal medicines such as fluconazole (taken by mouth), caspofungin (given by injection), or amphotericin (given by injection) can treat candida infection.
  • Antiviral medicines that are given through a vein (intravenously), such as ganciclovir or foscarnet can treat CMV infection. In some cases, a medicine called valganciclovir, which is taken by mouth, can be used for CMV infection.

Some people may also need pain medicine.

Many people who are treated for an episode of infectious esophagitis need other, long-term medicines to suppress the virus or fungus, and to prevent the infection from coming back.

Outlook (Prognosis):

Esophagitis can usually be treated effectively. Healthy people recover on their own in 3 - 5 days, but those with a weakened immune system take longer to get better.

The outcome depends upon the immune system problem that makes the person more likely to develop the infection.

Possible Complications:
  • Holes in your esophagus (perforations)
  • Infection at other sites
  • Recurrent infection
When to Contact a Medical Professional:

Call your health care provider if you have any condition that can cause reduced immune response and you develop symptoms of infectious esophagitis.

Prevention:

The herpes simplex virus can be contagious by direct contact, so avoid contact with known herpes sores (lesions).

References:

Graman PS. Esophagitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 94.


Review Date: 9/1/2013
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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