Gastric Ulcers Associated with Herpes Simplex Esophagitis in a Nonimmunocompromised Patient

Al-Samman, Mounzer; Zuckerman, Marc J.; Verghese, Abraham; Boman, Darius

doi:10.1097/00004836-199403000-00017

Cited by 10 publications

(6 citation statements)

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“…[11] Moreover, in approximately 2% of the patients HE may concomitantly involve the stomach as well. [30] Similarly to the majority of reported cases, our patient presented impairment of the middle and lower part of the esophagus with friable esophageal mucosa, multiple ulcerations, and whitish exudates, but no involvement of the stomach. Histological examination of the esophageal biopsy specimens established the diagnosis in most of the cases of HE, but virologic culture is another commonly used method for the confirmation of the diagnosis.…”

Section: Discussionsupporting

confidence: 76%

An uncommon case of herpetic esophagitis in a small child with allergic rhinitis

Mărginean¹,

Meliţ²,

Mocan

et al. 2019

Medicine

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Rationale: Herpetic esophagitis (HE) is a common condition in immunosuppressed patients, but a rare entity in immunocompetent patients affecting especially male teenagers and young adults. Patient concerns: We report the case of a 5-year-old male patient, with a history of allergic rhinitis admitted in our clinic for acute onset fever refractory to antipyretics, chest pain, anorexia, refusal of solid food, accepting only small amounts of fluids, odynophagia, and epigastric pain. The clinical exam revealed severe malaise, pallor, decreased skin turgor, abdominal epigastric tenderness, heartburn at palpation within the epigastric area. The laboratory tests showed leukocytosis, monocytosis, hypoglycaemia, and elevated inflammatory biomarkers. Diagnoses: The serology tests for human immunodeficiency virus (HIV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex virus (HSV) were negative, except for immunoglobulin G (IgG) anti-EBV which was positive. The chest radiography was normal, and the abdominal ultrasound showed abdominal bloating. The upper digestive endoscopy revealed friable esophageal mucosa, with multiple ulceration on the entire esophagus, and whitish exudates especially on the middle and lower part of the esophagus suggesting a possible eosinophilic esophagitis or caused by Candida. Despite the empirical initiated treatment, the patient's evolution was only slowly favorable. The histological exam established the diagnosis of HE. Interventions: We initiated acyclovir therapy with an outstandingly favorable evolution. Outcomes: After 1 month, we detected the seroconversion of IgG anti-HSV. The patient's follow-up revealed no additional complaints. Lessons: Despite its rarity in immunocompetent individuals, HE must be taken into account even in otherwise healthy small children. Allergic conditions might represent a predisposing factor for HE.

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Section: Discussionsupporting

confidence: 76%

An uncommon case of herpetic esophagitis in a small child with allergic rhinitis

Mărginean¹,

Meliţ²,

Mocan

et al. 2019

Medicine

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“…[1314] Males are more commonly affected than females with a ratio of 3.4:1. [15] Our patients’ presentations were similar to those described in the literature with the acute onset of the triad of odynophagia, retrosternal pain and fever which may be preceded by a flu-like prodrome for three to ten days.…”

Section: Discussionmentioning

confidence: 99%

Herpes simplex ulcerative esophagitis in healthy children

Al–Hussaini

Fagih

2011

Saudi J Gastroenterol

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Herpes simplex virus is a common cause of ulcerative esophagitis in the immunocompromised or debilitated host. Despite a high prevalence of primary and recurrent Herpes simplex virus infection in the general population, Herpes simplex virus esophagitis (HSVE) appears to be rare in the immunocompetent host. We report three cases of endoscopically-diagnosed HSVE in apparently immunocompetent children; the presentation was characterized by acute onset of fever, odynophagia, and dysphagia. In two cases, the diagnosis was confirmed histologically by identification of herpes viral inclusions and culture of the virus in the presence of inflammation. The third case was considered to have probable HSVE based on the presence of typical cold sore on his lip, typical endoscopic finding, histopathological evidence of inflammation in esophageal biopsies and positive serologic evidence of acute Herpes simplex virus infection. Two cases received an intravenous course of acyclovir and one had self-limited recovery. All three cases had normal immunological workup and excellent health on long-term follow-up.

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“…We reviewed all relevant English language articles and bibliographies of those articles on herpes esophagitis obtained through a PubMed search going back to 1970. Fifty‐one cases of herpes esophagitis have been reported 7–39 (Table 1). The mean age of patients with herpes esophagitis was 29 ± 21 years, and the male : female ratio was 3 : 6.…”

Section: Discussionmentioning

confidence: 99%

Herpes simplex esophagitis in the immunocompetent host

Kato

Yamamoto

Yoshimitsu

et al. 2005

Diseases of the Esophagus

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We report here a case of herpes esophagitis with Mallory-Weiss syndrome in an immunocompetent host. A 26-year-old man was admitted to our hospital because of common cold symptoms and eruptions on the body. On day 2 after hospitalization, the patient showed high-grade fever, odynophagia and hematemesis. Upper gastrointestinal endoscopic examination showed multiple ulcerations throughout the mid- and distal esophagus. Bleeding from a Mallory-Weiss tear was also seen. Follow-up endoscopic examinations showed whitish exudates on day 5. Histological examination of biopsy specimens showed Cowdry type A intranuclear inclusion bodies in epithelial cells. Positive staining of a specific antibody against herpes simplex virus-1 (HSV-1) was seen in the nuclei of esophageal epithelial cells. Primary HSV-1 infection was suspected because ELISA titers of serum IgM antibody against HSV-1 were high and titers of serum IgG antibody against HSV-1 increased from an almost cut-off ratio. A diagnosis of herpes esophagitis in an immunocompetent host was made. Our case is the first report of herpes esophagitis with Mallory-Weiss syndrome in the immunocompetent host. It is important to remind herpes esophagitis in cases of severe odynophagia even in immunocompetent hosts.

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Gastric Ulcers Associated with Herpes Simplex Esophagitis in a Nonimmunocompromised Patient

Cited by 10 publications

References 0 publications

An uncommon case of herpetic esophagitis in a small child with allergic rhinitis

An uncommon case of herpetic esophagitis in a small child with allergic rhinitis

Herpes simplex ulcerative esophagitis in healthy children

Herpes simplex esophagitis in the immunocompetent host

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