Infectious Diseases of the Esophagus

Abstract

This review considers the three most common infectious diseases affecting the esophageal mucosa: Candida organisms (particularly Candida albicans), cytomegalovirus (CMV), and herpes simplex virus (HSV), including their epidemiologies, pathogeneses, diagnoses, differentials, managements, complications, and prognoses. Infection is often indicated by the symptom of odynophagia, although more general gastrointestinal complaints such as dysphagia and heartburn can also be present. Esophageal candidiasis caused by C. albicans is the most common esophageal infection, detected in immunocompetent patients, as well as those with HIV infection, hematologic malignancies, or other immunologic disorders. Treatment of these diseases should target the fungal or viral pathogens involved using systemically active antibiotic regimens. As infectious esophagitis is frequently seen in immunocompromised hosts, assessment for HIV and malignancy should be considered with a new diagnosis. Figures show endoscopic images of Candida esophagitis and HSV esophagitis. Tables list risk factors for infectious esophagitis, possible symptoms of infectious esophagitis, pathogens causing infectious esophagitis and distinguishing characteristics, the Kodsi classification of Candida esophagitis severity on endoscopy, and treatment regimens for esophageal candidiasis, CMV esophagitis in HIV/AIDS patients, and HSV esophagitis. This review contains ­2 highly rendered figures, 8 tables, 38 references. Key words: Candida albicans, Cytomegalovirus (CMV), Herpes simplex virus (HSV), HIV Complications, Immunosuppression Treatment for Candida, CMV, and HSV, Infections of the esophagus