Herpetic esophagitis: a case report on an immunocompetent adolescent

Abstract

Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected clinically by an acute onset of symptoms, and without apparent cause of a symptomatic triad consisting on odynophagia, heartburn and fever.Its occurrence may be due to reactivation of a previous infection or less often a primary infection. Herpes simplex type 1 is the most common cause.Upper endoscopy establishes the diagnosis of suspicion of herpetic esophagitis. It also allows to take multiple biopsy samples and viral culture, leading to a definitive diagnosis.The severity of symptoms is related to the degree of oesophageal involvement. In immunocompromised patients treatment is indicated with acyclovir, but the indication in immunocompetent patients is controversial because the process is time, limited with a low probability of complications.We present a case of acute herpetic esophagitis in an immunocompetent host that debuted acutely with severe upper gastrointestinal tract symptoms, associated with an insidious and nonspecific onset of flu-like symptoms. Endoscopic findings showed a severe involvement in the lower third of the oesophageal mucosa.

Herpes Simplex Infection Masquerading as Esophageal Candidiasis in Immunocompetent Individuals: A Series of Two Cases

“…1,2 A clinician needs to have a high index of suspicion in a young healthy adult who presents with an acute onset of dysphagia, odynophagia, and epigastric pain. 3 Patients may or may not present with prodromal symptoms, such as, malaise, fever, pharyngitis, and cough. 3,4 Clinically, esophageal herpetic infections remain underdiagnosed unless the patient is immunocompromised.…”

“…3 Patients may or may not present with prodromal symptoms, such as, malaise, fever, pharyngitis, and cough. 3,4 Clinically, esophageal herpetic infections remain underdiagnosed unless the patient is immunocompromised. We report two cases of herpetic esophagitis in young immunocompetent patients.…”