Cytomegalovirus Esophagitis(Archived)

Excerpt

Cytomegalovirus (CMV) is a member of the Herpesviridae family, which has the largest genome of any herpes virus. It is spread through bodily fluids, such as during the perinatal period or sexual contact. Although immunocompetent individuals can be infected, the serious disease typically only manifests in those with immunocompromised states, such as patients with AIDS, organ transplant recipients, and patients on chemotherapy. CMV can affect many organs, including the eyes, stomach, and colon, but this discussion focuses on the esophagus. CMV esophagitis is the second most common gastrointestinal (GI) tract manifestation of CMV disease, the first being colitis. The typical manifestation of CMV esophagitis is odynophagia and dysphagia, and finding of large ulcer or ulcers in the middle to distal esophagus. Standard diagnosis requires biopsy and pathologic verification. Current treatment still consists of antivirals ganciclovir and valganciclovir, but research for alternatives is ongoing. Nonetheless, esophageal disease of CMV infection carries a poor prognosis, recurrence risk, and high rate of one-year morbidity and mortality.