Esophageal Cytomegalovirus and Herpes Simplex virus co-infection in an immunocompromised patient: Case report and review of literature

Abstract

Herpes simplex virus and Cytomegalovirus co-infection has been reported to occur in a variety of sites in immunocompromised patients. To our knowledge, few cases of such co-infection have been reported to occur in the esophagus. We report a case of a 60-year-old woman who was maintained on immunosuppressive therapy for a presumed diagnosis of pemphigus vulgaris, who presented with odynophagia. Investigations revealed ulcerative esophagitis caused by both HSV and CMV. The patient was treated with valganciclovir with full recovery. We also present the results of various studies on patients with similar presentation particularly those caused by HSV and CMV co-infection.

Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus

“…Synchronous infections of CMV and HSV can occur because these infections share predisposing factors. There were many cases of CMV and HSV coinfection in the skin, gastrointestinal tract, genital organs, and central nervous system [19][20][21][22]. Intranuclear and intracytoplasmic inclusions in the pathology of the tracheal mucosa are specific findings for CMV tracheitis [17].…”

Hematemesis in pemphigus vulgaris: A challenging case of isolated esophageal flare in patient in remission

“…Endoscopically, HSV infections have erosions and punched-out ulcerations with a yellow rim mostly in the distal esophagus whereas peptic ulcerations are irregular or linear shaped, multiple and more prominent in the distal esophagus. 12 Microscopically, herpetic infections would show multinucleation and intranuclear eosinophilic inclusion bodies. Pill (bisphosphonates, iron tablets, etc.)…”

Hämatemesis bei Pemphigus vulgaris: Ein herausfordernder Fall eines isolierten Ösophagusschubs bei einer Patientin in Remission

“…Während peptische Ulzerationen unregelmäßig oder linear geformt, multipel und im distalen Ösophagus deutlicher ausgeprägt sind. 12 Mikroskopisch zeigen sich bei herpetischen Infektionen eine Multinukleation sowie intranukleäre eosinophile Einschlusskörperchen. Eine durch Tabletten (Bisphosphonate, Eisentabletten usw.)…”