Herpes esophagitis
Definition
Herpes esophagitis is a viral infection that involves inflammation and ulcers in the esophagus, the tube that carries food from the mouth to the stomach.
Causes, incidence, and risk factors
The herpes simplex virus causes herpes esophagitis.
Infection of the esophagus by the herpes simplex virus is rare in people with normal immune systems and usually runs its course without treatment. However, severe and difficult-to-treat esophagitis can occur in people with a suppressed or weakened immune system.
The following raise your risk for herpes esophagitis:
- HIV/AIDS
- Chemotherapy
- Diabetes
- Leukemia or lymphoma
- Organ transplants
- Other conditions that suppress or weaken your immune system
Symptoms
Symptoms include:
- Chills
- Difficulty swallowing
- Fever
- Herpes in the mouth (herpes labialis)
- Joint pain or other general symptoms
- Painful swallowing
Signs and tests
- Culture of cells from the esophagus
- Esophagogastroduodenoscopy (EGD) with or without biopsy
Treatment
In most people, antiviral medication such as acyclovir, famciclovir, or valacyclovir can control the infection. Some people also need pain medicine. Many people who are treated for an episode of herpes esophagitis need other, long-term medicines to suppress the virus and prevent reinfection.
Expectations (prognosis)
Esophagitis can usually be treated effectively. Healthy people recover on their own in 3 - 5 days, but those with a weakened immune system take longer to get better.
The outcome depends upon the immune system problem that makes the person more likely to develop the infection.
Complications
- Holes in your esophagus (perforations)
- Infection at other sites
- Recurrent infection
Calling your health care provider
Call your health care provider if you have any condition that can cause reduced immune response and you develop symptoms of herpes esophagitis.
Prevention
The herpes simplex virus is contagious by direct contact, so avoid contact with known herpes sores (lesions).
References
Whitley RJ. Herpes simplex infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 397.
Review Date:8/28/2009
Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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