Infective oesophagitis: epidemiology, cause, diagnosis and treatment options

This review summarizes recent literature pertaining to infectious oesophagitis.

Infectious oesophagitis is an uncommon condition of the oesophagus caused by viral, bacterial or fungal agents. A compromised immune system is the most important risk factor for the development of infectious oesophagitis and HIV or AIDS and solid organ transplant patients are particularly at risk. Common symptoms of infectious oesophagitis include odynophagia and dysphagia, but it can be difficult to distinguish infectious oesophagitis from other causes of oesophagitis based on patient symptoms alone. Definitive diagnosis requires esophagoscopy with biopsy for histologic and microbiologic evaluation. Endoscopic findings differ based on cause. Overall, Candida albicans is the most common cause of infectious oesophagitis. Treatment of infectious oesophagitis is based on host immune status, the severity of infection and risk of complications. When seemingly adequate treatment is unsuccessful, alternative diagnoses should be entertained and additional biopsies and/or diagnostics obtained.

Recent research in infectious oesophagitis involves identifying preventive strategies for at-risk populations. Prevention may include use of probiotics, prophylactic medications and/or treatment of underlying immune dysfunction and could be important for susceptible individuals.