Throat Infection or Mouth Ulcer (Herpes Esophagitis): Cause, Symptoms, Diagnosis, Treatment, Outlook

The oesophagus is the tube that carries food and drink from your mouth to your stomach. Herpes esophagitis is the medical term used for specific throat infection. It is a viral infection of the oesophagus. It’s caused by the herpes simplex virus. Type 1 and type 2 can both cause herpes esophagitis, although herpes type 1 is more common.

Still, herpes esophagitis isn’t very common in healthy people. People who have weakened immune systems, such as from autoimmune conditions, cancer, HIV, or AIDS, are at an increased risk.

Herpes esophagitis can cause:

Inflammation

Damage to the oesophagus and throat tissues

Difficulty swallowing

Chest pain

If you have it, your doctor will watch you very closely and check for other illnesses or health problems.

How herpes esophagitis spreads

There are two types of the herpes simplex virus.

HSV-1

Herpes simplex virus type 1 (HSV-1) is the cause of most cases of herpes esophagitis. It’s the same virus type that causes cold sores. It’s generally passed through mouth-to-mouth contact through infected saliva. You can develop a throat infection through close contact with someone who has mouth ulcers, cold sores, or eye infections.

If you’re infected, you must wash your hands with soap and warm water to avoid spreading the virus to others. You should avoid contact with people who have an active infection. If you know or suspect that you’re infected, contact your doctor immediately and inform anyone that you’ve had close contact with. HSV-1 can also be transmitted to the genitals during oral sex.

HSV-2

Herpes simplex virus type 2 (HSV-2) is another form of the virus. It’s often considered a sexually transmitted infection. HSV-2 is spread through skin-to-skin contact and causes genital herpes.

HSV-2 rarely causes herpes esophagitis, but engaging in oral sex with someone who has an active herpes HSV-2 outbreak could lead to herpes esophagitis in some people. If you’re having a herpes outbreak, make sure to practice safe sex by using a condom or dental dam. Always inform your partner. The key to preventing herpes from spreading is catching it and starting early treatment.

Risk factors

Most people with strong immune systems won’t develop herpes esophagitis, even after being infected by the herpes virus. Your risk increases if you have:

HIV or AIDS

Leukaemia or other cancers

An organ transplant

Diabetes

Any illness that compromises your immune system

Any autoimmune disease, such as rheumatoid arthritis or lupus

People who abuse alcohol or take long-term antibiotics are also at greater risk. Taking certain oral medications or using steroid inhalers can affect your oesophagal lining and cause your oesophagus to become inflamed. This can also increase your risk.

Symptoms of herpes esophagitis

Symptoms of herpes esophagitis involve the mouth and other areas of the body. The primary symptoms include open sores in the mouth and difficulty swallowing. Swallowing may be painful due to the inflammation and ulceration of the throat tissues. The mouth sores are called herpes labialis.

Other signs of infection may include:

Joint pain

Chills

Fever

General malaise (not feeling well)

Diagnosing herpes esophagitis

Your doctor will ask you about your medical history. They may also look into your oesophagus with a small, lighted camera, called an endoscope.

Bacteria, fungi, and a range of other viruses can also cause infectious esophagitis. Other conditions such as strep throat or hand, foot, and mouth disease may mimic the symptoms of herpes esophagitis. Your doctor can use diagnostic tools to confirm that you have herpes esophagitis. These tests include:

Throat cultures

Mouth swabs

Blood tests

Urine tests

These tests can help your doctor identify the source of the infection. Your doctor will know that you have herpes esophagitis if they find the herpes virus specifically.

Treatment for herpes esophagitis

Medication can help treat esophagitis caused by the herpes virus. Over-the-counter pain relievers may help ease the pain. Your healthcare provider will also likely prescribe one of three antiviral drugs:

Acyclovir (Zovirax)

Famciclovir (Famvir)

Valacyclovir (Valtrex)

If your pain is severe, you may need prescription pain medication. Your doctor might also prescribe the antiviral medication on a long-term basis to prevent you from developing recurring infections.

What is the outlook for herpes esophagitis?

Recovery times vary depending on your health. People with healthy immune systems usually respond quickly to treatment and improve within a few days. People who have certain medical conditions may need more time to heal.

Scarring from the inflammation can sometimes make it difficult to swallow. A more serious, life-threatening complication is oesophagal perforation, which is a medical emergency. Herpes esophagitis rarely causes oesophagal perforation, though. Most people with herpes esophagitis won’t develop any serious, long-term health issues