Alternate Names: Herpes esophagitis

Causes and Risks:

Infection by the herpes simplex virus in individuals with normal immune systems usually runs its course without treatment, but severe and persistent esophagitis can occur in an immunosuppressed or immunodeficient person. The incidence is 1 out of 100,000 people. Herpes simplex esophagitis can occur in AIDS patients with very low CD4 counts.

Herpetic esophagitis causes excruciating pain when swallowing. The infections is frequently associated with fever and occasionally chills. Healthy individuals recover spontaneously in 3 to 5 days

Prevention:

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

Symptoms:

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

Signs 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 the antiviral medication, acyclovir, usually given intravenously.

Prognosis:

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

Complications:

Complications include recurrent infections.

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