Infectious Disease Compendium

Esophagitis

Diagnosis

Painful swallowing.

Epidemiologic Risks

Usually immunocompromised: HIV or chemotherapy.

Occasionally normal people get Herpes esophagitis with their first case of cold sores.

Microbiology

Candida (C. albicans and, in patients on long term fluconazole, non albicans Candida), Herpes (can occur in the normal host), CMV are the big three.

A hodgepodge of other organisms have been reported.

There are also a large number of non-infectious causes. Yawn.

Empiric Therapy

Depends on the diagnosis, might I suggest a diagnostic test, say, endoscopy, before embarking on a course of therapy? Might I? Please? Occasionally AIDS patients are treated with empiric fluconazole and then endoscoped if symptoms persist.

Pearls

Patients with Candida esophagitis do not necessarily have Candida in the mouth. But. In HIV, oral thrush has a sensitivity of 53% and a positive predictive value of 77% for Candida esophagitis (PubMed) .

The British, amusingly, misspell it oesophagitis.

Rants

Last Update: 07/10/18.

I try not to say oral thrush, because is not thrush oral?