Herpes esophagitis

Definition

Causes

Infection of the esophagus by the herpes simplex virus in individuals with normal immune systems is very rare and usually runs its course without treatment, but severe and persistent esophagitis can occur in an immunosuppressed or immunodeficient person.

Herpetic esophagitis causes excruciating pain when swallowing. The infection is frequently associated with fever and occasionally chills. Healthy individuals recover spontaneously in 3 to 5 days but those with weakened immune systems take longer.

Symptoms

• difficulty swallowing
• painful swallowing
• herpes in the mouth may be present (Herpes labialis)
• more generalized symptoms such as joint pain may be present

Exams and Tests

• an EGD (esophagogastroduodenoscopy) with biopsy showing herpes
• a culture of cells from esophageal brushings showing herpes
• an esophagogastroduodenoscopy showing herpes lesions

Treatment

The objective of treatment is to control the infection with antiviral medications, usually acyclovir. Pain medicine can also be given.

Outlook (Prognosis)

Esophagitis can usually be treated effectively. The outcome depends upon the underlying immunodeficiency that makes the person more susceptible to the infection.

Possible Complications

Complications include recurrent infections.

When to Contact a Medical Professional

Call your health care provider if you have any condition that may result in reduced immune response and symptoms of esophagitis herpes develop.

Prevention

The herpes simplex virus is contagious by direct contact, so avoid contact with known herpes lesions.

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Illustrations and Images

Herpetic esophagitis

Upper gastrointestinal system

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Review Date: 2/13/2006
Reviewed By: Monica Gandhi, M.D., M.P.H., Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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