CMV esophagitis

Also known as: Cytomegalovirus esophagitis

Definition

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

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.

Review date:: August 28, 2009
Reviewed by:: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.