Micrograph of an esophageal biopsy showing<unk>  eosphagitis, with the characteristic nuclear changes (nuclear moulding, chromatin clumping at the nuclear membrane (margination) and multinucleation). H&E stain. Upper Endoscopy often reveals ulcers throughout the esophagus with intervening normal-appearing mucosa. In severe cases the ulcers can coalesce and on rare occasions have a black appearance known as black esophagus. While the diagnosis of<unk>  can be inferred clinically it can only be accurately diagnosed through endoscopically obtained biopsies with microscopic evaluation by a pathologist finding the appropriate inclusion bodies and diagnostic immunochemical staining. False negative findings may occur if biopsies are taken from the ulcer rather than from the margin of the ulcer as the inclusion particles are to be found in viable epithelial cells. Viral tissue culture represents the most accurate means of diagnosing the precise cause. Differential diagnosis CMV, VZV as well as HIV infections of the esophagus can have a similar presentation. Tissue culture is the most accurate means of distinguishing between the different viral causes. Caustic<unk> , pill-induced<unk>  as well as yeast<unk>  can have a similar clinical presentation.
Herpes esophagitis
Cytomegalovirus esophagitis
Lymphocytic esophagitis
Eosinophilic esophagitis
Esophageal candidiasis
Barrett's esophagus
Nutcracker esophagus
Atrophic gastritis