Infection of the Esophagus

Infection of the esophagus occurs mainly in people who have impaired defense mechanisms that protect the esophagus from infection. The main causes of infection are Candida albicans, herpes simplex virus, and cytomegalovirus.

The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach. (See also Overview of the Esophagus.)

There are several defense mechanisms that protect the esophagus against infection. These defenses include saliva, the normal movement (contractions) of the esophagus, and the cells of the immune system.

In healthy people, these defenses prevent infection. However, people who have impaired defenses, such as those who have HIV, an organ transplant, alcohol use disorder, diabetes, a weakened or impaired immune system, undernutrition, cancer, or movement (motility) disorders of the esophagus, are at risk of infection. Additionally, swallowed or inhaled corticosteroids may put people at increased risk of infection of the esophagus. Candida infection may occur in any of these people.

Herpes simplex virus infection and cytomegalovirus infection of the esophagus occur mainly in people who have HIV or who have had an organ transplant and are taking medications that suppress the immune system.

Diagnosis of Esophageal Infection

• Endoscopy

Sometimes, the doctor can see signs of Candida infection in the mouth (thrush) in people who have Candida infection of the esophagus. Usually there are no abnormalities in the mouth of people with herpes simplex virus infections or cytomegalovirus infection.

To diagnose an infection of the esophagus, usually the doctor looks down the esophagus using a flexible viewing tube (endoscopy). During endoscopy, doctors usually remove tissue for examination under a microscope (biopsy).

Infection of the Esophagus Caused by Candida

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This photo shows whitish spots in the esophagus that are typical of infection with the yeast Candida.

Image provided by Kristle Lynch, MD.