**2. Etiology**

The causes of infectious esophagitis are many and they involve [5–13]J:


The risk factors of infectious esophagitis include antibiotics and steroids use, chemotherapy, radiation therapy, malignancies and immunodeficiency syndromes like the acquired immunodeficiency syndrome (AIDS). Additional diseases linked to increase in the incidence of Candida esophagitis include esophageal stasis, alcoholism, malnutrition, and advanced age. Occasionally, Candida esophagitis can occur in otherwise healthy individuals with no underlying esophageal or systemic disease [7–13].

Additional typical risk factors such as acute onset of symptoms such as dysphagia and odynophagia are also remarkable in some cases of infectious esophagitis. The disease may coexist with heartburn, retrosternal pain, nausea and sometimes vomiting. Occasionally, patients can present with abdominal pain, anorexia, weight loss and cough. Infectious esophagitis is frequently caused by *Candida* organisms. Other important causes include CMV and HSV infection.

Again, people presenting with generalized sepsis, low neutrophil counts, AIDS, burns, trauma etc., can have rare infectious esophagitis. Severe esophagitis with very deep ulcers and fistulous tracts to the mediastinum, pleural space, tracheobronchial tree, skin and other tissues can be due to actinomycosis. The appearance of characteristic sulfur granules on endoscopic biopsy specimens can confirm the diagnosis of infectious esophagitis. The most notable risk factor for infectious esophagitis in people with HIV is reoccurring low CD4 count. However, it has also

been suggested that people can develop fungal esophagitis during the seroconversion phase of the process [5, 7–13].
