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Infection of the Esophagus
Infection of the esophagus occurs mainly in people who have impaired defense mechanisms that protect the esophagus from infection. The main causes of infection are Candida albicans, herpes simplex virus, and cytomegalovirus.
There are several defense mechanisms that protect the esophagus against infection. These defenses include saliva, the normal movement (motility) of the esophagus, and the cells of the immune system. Thus, people at risk include those who have AIDS, an organ transplant, alcoholism, diabetes, undernutrition, cancer, or movement (motility) disorders of the esophagus. infection (see Candidiasis) may occur in any of these people. Herpes simplex virus infections ( Herpes Simplex Virus Infections) and cytomegalovirus infection ( Cytomegalovirus (CMV) Infection) occur mainly in people who have AIDS or who have had an organ transplant and are taking immunosuppressant drugs.
Pain with swallowing (odynophagia) is the typical symptom. Some people also notice difficulty swallowing (dysphagia—see Difficulty Swallowing). These infections also cause ulcers (sores) and irritation and swelling of the esophagus (esophagitis).
Sometimes, the doctor can see signs of Candida infection in the mouth (thrush—see Candidiasis) in people who have Candida infection of the esophagus. Usually there are no abnormalities in the mouth of people with herpes simplex virus infections or cytomegalovirus infection. To diagnose an infection of the esophagus, usually the doctor looks down the esophagus using a flexible viewing tube with a camera on the end (esophagoscopy—see Endoscopy).
People with Candida are given an antifungal drug such as fluconazole. The drug is given by mouth or, if people are having trouble swallowing, by injection into a vein.
People with herpes simplex virus infections or cytomegalovirus infection are given antiviral drugs such as acyclovir or ganciclovir by injection into a vein.
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