Infective Esophagitis.

Abstract

Infectious esophagitis is caused by a viral, fungal, or bacterial infection of the esophagus. The most common viral pathogens are cytomegalovirus (CMV) and herpes simplex virus (HSV); Candida is the most common fungal pathogen. Bacterial esophagitis is rare, typically occurring only in immunocompromised individuals, and is often caused by the reactivation of a latent infection. The symptoms of infectious esophagitis range from an asymptomatic presentation to dysphagia, chest pain, and fever. Diagnoses are based on endoscopic findings and biopsy results for pathogen identification. In immunocompromised patients, treatment involves the use of antimicrobial agents. CMV esophagitis is characterized by esophageal ulcers visible during endoscopy and is diagnosed when intranuclear or cytoplasmic inclusions are observed in biopsy samples. Patients with HSV esophagitis present with volcano-like ulcers visible during endoscopy and are treated with acyclovir. Candida esophagitis is identified by the presence of white plaques and is treated using fluconazole. Although rare, bacterial esophagitis can be caused by Mycobacterium tuberculosis or oral/respiratory tract bacteria. This form of infectious esophagitis presents as nonspecific esophagitis during endoscopy; patients are treated using antibiotics. This review discusses the causative pathogens, endoscopic features, diagnosis, and treatment of infectious esophagitis.