Most infective esophagitis is found in children that are immunocompromised. These children  do not have resistance to infection or are on medication that reduce their immune response.

The commonest infections are herpes simplex, cytomegalovirus (CMV) and candida (thrush). Infection usually follows assault to the esophagus such as inflammation or trauma.

In herpes and candida the child may complain of pain and difficulty on swallowing. Endoscopy and biopsy will confirm diagnosis.

In children with normal functioning immune system, these viral infections subside spontaneously. It is, however, a problem with an immuno-compromised child.

Candida is commonest of all the esophageal infections. Areas of white plaques looking like milk curds that does not move when probed is typical in candidiasis. Oral candida does not suggest candida of the esophagus.

Inappropriate steroid used can lead to candida infections. Poor inhaler technique is asthma can result in steroid deposits in the back of the throat and subsequent candida infection.
Candida can cause perforation, fistula and stricture but this is uncommon.  A course of oral treatment for candida is very effective in both normal and immuno-compromised children.

There are other types of organisms that can infect the esophagus but infections from these microbes are rare.

Dr. Phil Hariram.