Which of the following statement(s) is/are true concerning infectious esophagitis?

d.Small ulcers on barium esophogram in a transplant patient complaining of dysphagia and odynophagia are likely due to herpes simplex viral infection

Chronic debilitation, immunosuppression, and prolonged use of antibiotics predisposes the development of infectious esophagitis with candida albicans being the most common cause. Candida albicans is a fungus that normally is a commensal inhabitant of the mouth, oral pharynx, and GI tract. This fungus may become pathogenic in patients who are severely debilitated or immunosuppressed. In recent years, the use of broad spectrum antibiotics, immunosuppression in organ transplant patients, and the wide use of chemotherapeutic agents have resulted in an increased number of patients with monilial esophagitis. As the disease progresses, transmural invasion of the esophageal wall occurs. Although the esophagitis can be controlled with antifungal therapy, if the patient survives the underlying illness, chronic stricture formation may result after healing. Minimally compromised patients with mild monilial esophagitis should receive oral nystatin suspension as a primary treatment. More immunosuppressed patients or those with severe cases warrant high doses of fluconazole and ketoconazole. Intravenous fluconazole or amphotericin B are utilized in granulocytopenic patients. Viral esophagitis is the second most common cause of infectious esophagitis. Herpes simplex viral infection is the most common infection in the immunosuppressed transplant patient. Characteristically, viral esophagitis produces mucosal ulceration with patients presenting with dysphasia and odynophagia. The esophageal ulcers are characteristically small (< 1.5 cm). The diagnosis is established endoscopically by biopsy, brushings, and washings for cytology, histology, and viral culture. The infection usually responds well to treatment with acyclovir.