Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Infection of the Esophagus

By

Kristle Lee Lynch

, MD, Perelman School of Medicine at The University of Pennsylvania

Reviewed/Revised Feb 2024
VIEW PROFESSIONAL VERSION
Topic Resources

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 (contractions) of the esophagus, and the cells of the immune system.

In healthy people, these defenses prevent infection. However, people who have impaired defenses, such as those who have HIV, an organ transplant Complications After Transplantation Transplantation is the removal of living, functioning cells, tissues, or organs from the body and then their transfer back into the same body or into a different body. The most common type of... read more , alcohol use disorder Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,... read more , diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more , a weakened or impaired immune system, undernutrition Undernutrition Undernutrition is a deficiency of calories or of one or more essential nutrients. Undernutrition may develop because people cannot obtain or prepare food, have a disorder that makes eating or... read more Undernutrition , cancer, or movement (motility) disorders of the esophagus Abnormal Propulsion of Food The movement of food from mouth to stomach requires normal and coordinated action of the mouth and throat, propulsive waves of muscular contractions of the esophagus (called peristalsis), and... read more , are at risk of infection. Additionally, swallowed or inhaled corticosteroids may put people at increased risk of infection of the esophagus. Candida infection Candidiasis (Yeast Infection) Candidiasis is infection with the yeast Candida. Candidiasis tends to occur in moist areas of the skin. This skin infection may cause rashes, scaling, itching, and swelling. Doctors examine... read more Candidiasis (Yeast Infection) may occur in any of these people.

Did You Know...

  • Saliva helps protect the esophagus from infection.

Symptoms of Esophageal Infection

Esophageal infections also cause ulcers (sores) and irritation and swelling of the esophagus (esophagitis).

Diagnosis of Esophageal Infection

  • Endoscopy

Sometimes, the doctor can see signs of Candida infection in the mouth (thrush Candidiasis (Yeast Infection) Candidiasis is infection with the yeast Candida. Candidiasis tends to occur in moist areas of the skin. This skin infection may cause rashes, scaling, itching, and swelling. Doctors examine... read more Candidiasis (Yeast Infection) ) 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 (endoscopy Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube (endoscope). In addition to examinations, doctors can use endoscopy to do biopsies and give treatment. Endoscopes... read more ). During endoscopy, doctors usually remove tissue for examination under a microscope (biopsy).

Treatment of Esophageal Infection

  • For Candida infection, antifungals

  • For herpes simplex virus or cytomegalovirus infection, antivirals

People with Candida are given an antifungal such as fluconazole. The medication is given as a pill or, if people are having trouble swallowing, it can be given by injection into a vein.

People with herpes simplex virus infections are given antivirals such as acyclovir, valacyclovir, or famciclovir. They are given by mouth or by injection into a vein.

People with cytomegalovirus infection are given antivirals such as ganciclovir given by injection into a vein or valganciclovir given by mouth.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Diflucan
Sitavig, Zovirax, Zovirax Cream, Zovirax Ointment, Zovirax Powder, Zovirax Suspension
Valtrex
Famvir
Cytovene, Vitrasert, Zirgan
Valcyte, Valcyte Powder
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
VIEW PROFESSIONAL VERSION
quiz link

Test your knowledge

Take a Quiz!
iOS ANDROID
iOS ANDROID
iOS ANDROID
TOP