Esophagitis - infectious: MedlinePlus Medical Encyclopedia

P Esophagitis is a general term for any inflammation, irritation, or swelling of the esophagus. This is the tube that carries food and liquids from the mouth to the stomach.

T Causes
P Infectious esophagitis is rare. It often occurs in people whose immune systems are weakened. People who have strong immune systems don't usually develop the infection.
P Common causes of a weakened immune system include:
- HIV/AIDS
- Chemotherapy
- Diabetes
- Leukemia or lymphoma
- Medicines that suppress the immune system, such as ones given after organ or bone marrow transplant
- Other conditions that suppress or weaken your immune system
P Organisms (germs) that cause esophagitis include fungi, yeast, and viruses. Common organisms include:
- Candida albicans
- Cytomegalovirus (CMV)
- Herpes simplex virus (HSV)
- Human papillomavirus (HPV)
- Tuberculosis bacteria

T Symptoms
P Symptoms of esophagitis include:
- Difficulty swallowing and painful swallowing
- Fever and chills
- Yeast infection of the tongue and lining of the mouth (oral thrush)
- Sores in the mouth or back of the throat (with herpes or CMV)

T Exams and Tests
P The health care provider will ask about your symptoms and examine your mouth and throat. Tests may include:
- Blood and urine tests for CMV
- Culture of cells from the esophagus for herpes or CMV
- Mouth or throat swab culture for candida
P You may need to have an upper endoscopy exam. This is a test to examine the lining of the esophagus.

T Treatment
P In most people with esophagitis, medicines can control the infection. These include:
- Antiviral medicines 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.
P Some people may also need pain medicine.
P Ask your provider for special diet recommendations. For example, there may be foods you need to avoid eating as your esophagitis heals.
P 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.

T Outlook (Prognosis)
P Esophagitis can usually be treated effectively and usually heals in 3 to 5 days. People with a weakened immune system may take longer to get better.

T Possible Complications
P Health problems that may result from infectious esophagitis include:
- Holes in your esophagus (perforations)
- Infection at other sites
- Recurrent infection

T When to Contact a Medical Professional
P Call your provider if you have any condition that can cause reduced immune response and you develop symptoms of infectious esophagitis.

T Prevention
P If you have a weakened immune system, try to avoid contact with people who have an infection with any of the organisms mentioned above.

T Alternative Names
P Infection - esophagus; Esophageal infection

T Images
- Herpetic esophagitis
- Upper gastrointestinal system
- CMV esophagitis
- Candidal esophagitis

T References
P Graman PS. Esophagitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 99.
P Katzka DA. Esophageal disorders caused by medications, trauma, and infection. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 46.

T Review Date 9/10/2015
P Updated 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, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

