What is the most common presentation for a patient with CMV esophagitis?

Cytomegalovirus (CMV) esophagitis is primarily seen in immunocompromised patients, such as those with HIV, organ transplants, or those on immunosuppressive therapies. The hallmark of CMV esophagitis is the presence of characteristic linear ulcerations located primarily in the distal esophagus. These ulcers can be identified during endoscopy and are often associated with inflammation caused by the cytomegalovirus.

The appearance of linear ulcerations is linked to the virus's ability to cause necrosis of the epithelial layer of the esophagus, leading to these distinctive lesions. While other conditions could present with submucosal edema, frothy urine, or patchy infiltrates, these are not typical features of CMV esophagitis and lack the specific presentation of linear ulcers that are crucial for diagnosis. Therefore, understanding these linear ulcerations helps in the accurate identification and management of CMV esophagitis in affected patients.