INFECTIOUS ESOPHAGITIS By : MUTHANNA AL_LAMI

Objectives Introduction. Causes . Risk factors . Symptoms . Diagnosis . Differential diagnosis . Treatment. Complications . Conclusion.

Introduction Esophagitis is a general term for any inflammation, irritation, or swelling of the esophagus. Which is the tube that carries food and liquids from the mouth to the stomach. It often occurs in people whose immune systems are weakened. Infectious esophagitis mostly caused by virus or yeast.

Causes HSV CANDIDA ALBICANS CMV

 the most common infection that causes infectious esophagitis is Candida, which has a very characteristic endoscopic appearance (multiple yellow plaques). Viral esophagitis, which is probably the second most common cause of infectious esophagitis, results in ulceration of the esophagus, although it may be variable in appearance. Cytomegalovirus tends to cause larger ulcers than does herpes simplex virus, but a biopsy should be able to distinguish between these 2 infections. 

RISK FACTORS HIV/AIDS Cancer treatments, including chemotherapy and radiation treatments Diabetes Bone marrow or stem-cell transplant treatment Medicines that depress the immune system, such as steroids or medicines taken after an organ transplant Long-term antibiotic use Alcohol abuse

SYMPTOMS

Pain when swallowing(odynophagia). Difficulty swallowing(dysphagia). Heartburn . Mouth pain Chest pain Nausea or vomiting Chills or fever

DIAGNOSIS

Lab test is used to confirm if there is any infection by the changing of blood cells count . Endoscopy is a long thin tube equipped with a tinny camera is guided through the throat and into the esophagus to visulaised the mucosa layer for any changes like ulcers , color changes , yellow plaque or swelling . Biopsy is done to differentiate between the infectious microorganisms.

Differential diagnosis GERD . Eosinophilic gastrointestinal diseases . Hypereosinophilic syndrome . Achalasia . Drug hypersensitivity . Connective tissue disease. Graft –versus-host disease .

TREATMENT

 all of the infectious causes of esophagitis can be treated with some type of medication, oral or intravenous, and the medications are generally effective. Identifying the specific cause for esophagitis is very important, as the antimicrobial therapy can be targeted effectively to yield a cure. fluconazole for Candida. Acyclovir for HSV Gancyclovir or foscarnet for CMV Antacids ,topical anesthetics can be used additionally .

Complications

Generally esophagitis if left untreated can lead to changes in the structure and the main possible main complications include : Narrowing of the esophagus (esophageal stricture). Barrett’s esophagus characterized by changes to the cells lining the esophagus increasing the risk of esophageal cancer.

Conclusion Infectious esophagitis is very rare to occur in pepole with normal or good immunity. This kind of infection is very treatable if it is diagnosed correctly and early . If the infection is neglected and not treated properly it may lead to very significant complications . Unlike in reflux esophagitis, lifestyle modification is not effective in patients with infectious esophagitis. 

References https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=134&ContentID=169 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980995/ https://medlineplus.gov/ency/article/000646.htm https://www.webmd.com/digestive-disorders/esophagitis#1

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