Infectious esophagitis

Infectious esophagitis is relatively rare in an immunocompetent host. The presence of an esophageal infection is usually indicative of an impairment of either local or systemic defense mechanisms that normally act to prevent the colonization of a digestive organ that has a relatively transient contact with swallowed microbes. The spectrum of esophageal infections has changed over the past few decades. Esophageal infections were rare before the advent of acquired immune deficiency syndrome (AIDS) and posttransplant immunosuppressive treatment regimens with case reports largely confined to autopsy series. The explosion in opportunistic esophageal infections heralded by human immunodeficiency virus (HIV) and medication treatment-induced immunosuppression has been largely reversed by the efficacy of highly active retroviral therapy (HAART) in treating HIV and refinements in immunosuppressive therapy and transplant management in general [ 1– 3 ]. Nevertheless, socioeconomic barriers to widespread availability of HAART, a lack of compliance, and continued use of immunosuppressive therapy in a variety of diseases will likely perpetuate the morbidity from esophageal infections.