CMV Esophagitis

Definition
CMV esophagitis is an infection of the esophagus caused by the cytomegalovirus (CMV).

Causes, incidence, and risk factors

CMV esophagitis usually affects immunosuppressed or immunodeficient people. It causes esophageal ulcers with very painful and difficult swallowing. Oral lesions, often in the form of mouth ulcers, may also be present.

Symptoms

     
  • low grade fever  
  • difficult and painful swallowing  
  • oral lesions (mouth sores)

Signs and tests

     
  • EGD (esophagogastroduodenoscopy) with a biopsy  
  • culture of cells obtained from an esophageal brushing  
  • esophagogastroduodenoscopy shows CMV by culture  
  • blood and urine culture shows CMV  
  • cold agglutinins may be drawn  
  • CMV antigenemia in the blood may be positive

Treatment

Most specialists suggest treatment with antiviral medications that are given through a vein (intravenous). Usually, ganciclovir or foscarnet are given. A newer oral medication called valganciclovir is being studied for potential use.

Expectations (prognosis)
Esophagitis can usually be treated effectively. The outcome depends upon the underlying immunodeficiency that makes the person more susceptible to the infection.

Complications

     
  • recurrent infection  
  • infection at other sites

Calling your health care provider

Call your health care provider if symptoms of esophagitis CMV develop, especially if you are immunosuppressed.

Prevention

Prevention of AIDS prevents opportunistic infections, such as those caused by the cytomegalovirus. (Opportunistic infections are infections by organisms that are not normally disease-producing, but take advantage of a situation, such as a damaged immune system.) AIDS patients who are effectively treated with antiretroviral therapy are much less likely to get CMV infection.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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