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Gastrointestinal

CMV esophagitis

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Definition

Cytomegalovirus (CMV) esophagitis is a viral infection of the esophagus, the muscular tube through which food travels from the mouth to the stomach.

See also:

  • CMV gastroenteritis
  • CMV retinitis
  • Cytomegalovirus - immunocompromised host
  • Congenital cytomegalovirus

Alternative Names

Cytomegalovirus esophagitis

Causes, incidence, and risk factors

CMV esophagitis is caused by the cytomegalovirus (CMV).

The condition is often a sign of a weakened immune system. The following conditions raise your risk for CMV infections:

  • HIV/AIDS
  • Chemotherapy
  • Diabetes
  • Leukemia or lymphoma
  • Organ transplants
  • Other conditions that suppress or weaken your immune system

Symptoms

Symptoms include:

  • Difficult and painful swallowing
  • Low-grade fever
  • Mouth sores (oral lesions)

Signs and tests

  • Blood and urine culture
  • CMV antigenemia
  • Cold agglutinins
  • Culture of cells obtained from an esophageal brushing
  • Esophagogastroduodenoscopy (EGD) with or without a biopsy

Treatment

Treatment involves antiviral medications that are given through a vein (intravenously), such as ganciclovir or foscarnet. In some cases, patients are given an antiviral medicine called valganciclovir, which is taken by mouth.

Some people with this condition also need pain medicine.

Many people who are treated for an episode of CMV esophagitis take medicine to suppress the CMV for a long time.

Expectations (prognosis)

Esophagitis can usually be treated effectively. The outcome depends on the immune system problem that makes the person more likely to get the infection.

Complications

  • Infection at other sites
  • Holes in your esophagus (perforations)
  • Recurrent infection

Calling your health care provider

Call your health care provider if you develop symptoms of CMV esophagitis, especially if you have a suppressed immune system.

Prevention

Preventing AIDS can help avoid opportunistic infections, such as those caused by CMV. Opportunistic infections are caused by organisms that do not usually lead to disease, but that take advantage of a damaged immune system. People with AIDS who are effectively treated with antiretroviral therapy are much less likely to get CMV infection.

References

Drew WL. Cytomegalovirus. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 399.

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