Esophagitis Flashcards
DDx for esophagitis
- infectious
- inflammatory-IBD
- eosinophilic
- GVHD
- Caustic ingestion
- radiation induced
Risk factors for infectious esophagitis?
- immunocompromised host (congenital or acquired)
- steroids
- severe malnutrition
- mucositis
- broad spectrum antibiotics use
- PPI
- Stasis: achalasia, scleroderma
- Eso disease: GERD, EoE
Fungal eso infection EGD, Histo, Rx
EGD: adherent plaques on eso wall
Histo: hyphae and unicellular form
+ silver, PAS, GRAM stains
Rx: flucanazole
Complications: fungal ball & stricture (rare)
HSV eso infection EGD, Histo, Dx, Rx
affects stratified epithelium
EGD: herpetic vesicles (1-2 days)
Volcano ulcer-round lesion with yellow border
Histo: nuclear inclusions, multinucleated giant cell, mononuclear infiltrates
Dx: viral culture, IHC stain
Rx: immunocompetent - self limited
compromised- acyclovir
CMV eso infection EGD, Histo, Dx, Rx
EGD: similar to HSV but more deep and linear ulcers
mid to distal eso
Histo: basophilic inclusion bodies on biopsy from edge of ulcer
Rx: ganciclovir or foscarnet