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Gastrointestinal

Herpes esophagitis

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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.

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