Definition and etiology
• Injury of the esophageal mucosa due to fungi, viruses, etc. and other microorganisms is defined as 'infectious esophagitis'.• It is frequently seen after the underlying immunosuppressive disease (HIV), long-term immunosuppressive drug use, chemotherapy or transplant. It is rare in healthy individuals.
Candida Esophagitis
• It is the most common cause of infectious esophagitis (The most common type is Candida Albicans).• It is mostly seen in immunosuppressives. It may also develop in severe esophageal hypomotility (achalasia, scleroderma, etc.).
• Its most important symptom is odynophagia.
• In all suspected cases, the first and urgent procedure is endoscopy.
• Isolated white plaques on hyperemic mucosa are typical in endoscopy.
• Definitive diagnosis is made by the detection of candida pseudohyphae in the swab.
• The drug of choice in treatment is fluconazole. In resistant cases, voriconazole, posaconazole or caspofungin are given.
Viral Esophagitis
• They are almost always seen with herpes group viruses (most commonly HSV-1) and in immunosuppressed individuals, especially transplant recipients.• Clinically, odynophagia is the most important finding.
• HSV esophagitis is mostly in the form of diffuse multiple vesicular lesions. Intranuclear inclusion bodies (Cowdry A) can be seen in the biopsy taken.
• Serpenginous (wavy) ulceration is typical in CMV esophagitis. Biopsy shows both intranuclear and intracytoplasmic inclusion bodies
• Acyclovir is used in the treatment of HSV. Famciclovir and valaciclovir are alternatives.
• Ganciclovir or valganciclovir is used in CMV esophagitis.