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.

Empiric Therapy

Depends on the diagnosis, might I suggest a diagnostic test, say, endoscopy, before embarking on a course of rx? 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.

Rants

ICD9 Codes (Soon to be supplanted by ICD10)

Esophagitis 530.10; acute 530.12; candidal 112.84; reflux 530.11; specified NEC 530.19; ulcerative 530.19.