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Acute phlegmonous esophagitis
Prashant Gopal1, Amol Dahale2, Aniket Payagude3
1Medical Gastroenterology, Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India.
BMJ Case Reports
|November 9, 2024
Summary
Acute phlegmonous esophagitis (APE), a rare bacterial infection, presents with severe symptoms like chest pain and difficulty swallowing. Early diagnosis via CT scans and prompt treatment with antibiotics are crucial for survival.
Area of Science:
- Gastroenterology
- Infectious Diseases
Background:
- Acute phlegmonous esophagitis (APE) is a rare but serious bacterial infection affecting the esophagus.
- It typically involves the submucosal and muscularis layers, leading to severe symptoms.
Observation:
- Two young female patients presented with dysphagia and odynophagia, indicative of APE.
- Risk factors included prior surgery and uncontrolled diabetes.
- CT scans revealed diffuse esophageal thickening, while endoscopy showed erythema and ulcerations.
Findings:
- Both patients were successfully managed with intravenous antibiotics and supportive care.
- Computed tomography (CT) is identified as the preferred non-invasive diagnostic tool.
- Early diagnosis and treatment are critical due to APE's high mortality rate.
Implications:
- Prompt medical intervention, including antibiotics and nutritional support, is vital for APE management.
- Surgical or endoscopic intervention may be necessary for non-responsive cases or complications.
- This case series highlights the importance of considering APE in patients with relevant risk factors and symptoms.
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