Herpes esophagitis: a comprehensive review

Généreau, T; Rozenberg, Flore; Bouchaud, Olivier; Marche, C; Lortholary, Olivier

doi:10.1111/j.1469-0691.1997.tb00275.x

Cited by 37 publications

(52 citation statements)

References 119 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, previously published series revealed that histopathological examination alone may miss the diagnosis whereas adding tissue viral culture enhances the diagnostic sensitivity (2,19). To optimize HSV-1 esophagitis diagnosis, HSV-1 DNA detection by PCR assay has been described as a more sensitive, rapid, and easier diagnostic tool than viral culture, allowing an efficient etiological diagnosis in order to initiate early antiviral treatment (9). The aim of the present study was to assess the advantage of the esophageal biopsy specimen testing by quantitative real-time HSV PCR assay by comparing the results obtained to those of histopathological examination, which is considered the gold standard.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Virological Diagnosis of Herpes Simplex Virus 1 Esophagitis by Quantitative Real-Time PCR Assay

et al. 2012

View full text Add to dashboard Cite

Herpes simplex virus 1 (HSV-1) esophagitis diagnosis is routinely based on the endoscopic findings confirmed by histopathological examination of the esophagitis lesions. Virological diagnosis is not systematically performed and restricted to viral culture or to qualitative PCR assay from esophagitis biopsy specimens. The aim of this study was to assess the interest of quantitative real-time PCR assay in HSV-1 esophagitis diagnosis by comparing the results obtained to those of histological examination associated with immunohistochemical staining, which is considered the "gold standard." From 53 esophagitis biopsy specimens, the PCR assay detected HSV-1 in 18 of 19 histologically proven to have herpetic esophagitis and in 9 of 34 that had esophagitis related to other causes, demonstrating sensitivity, specificity, positive predictive value, and negative predictive value of 94.7%, 73%, 66.7%, and 96%, respectively. Interestingly, HSV-1 was not detected in 16 specimens without the histological aspect of esophagitis. The viral loads normalized per g of total extracted DNA in each biopsy specimen detected positive by HSV PCR were then compared and appeared to be significantly higher in histopathologically positive herpetic esophagitis (median ‫؍‬ 2.9 ؋ 10 6 ؎ 1.1 ؋ 10 8 ) than in histopathologically negative herpetic esophagitis (median ‫؍‬ 3.1 ؋ 10 3 ؎ 6.2 ؋ 10 3 ) (P ‫؍‬ 0.0009). Moreover, a receiver operating characteristics analysis revealed that a viral load threshold greater than 2.5 ؋ 10 4 copies would allow an HSV-1 esophagitis diagnosis with a sensitivity and specificity of 83.3% and 100%, respectively. In conclusion, this work demonstrated that HSV quantitative PCR results for paraffin-embedded esophageal tissue was well correlated to histopathological findings for an HSV-1 esophagitis diagnosis and could be diagnostic through viral load assessment when histopathological results are missing or uncertain. Herpes simplex virus 1 (HSV-1) is the second most common infectious etiological cause of esophagitis after Candida albicans (15,18,22). HSV-1 esophagitis is well documented in immunocompromised patients, whereas this clinical entity is rare in immunocompetent patients (2,4,5,9). HSV-1 esophagitis may represent a primary infection in particular in the immunocompetent host but is commonly due to a reactivation of a latent infection in the immunocompromised host (7).Friable mucosa, numerous ulcers, and whitish exudates commonly involving the distal or the midesophagus are classical endoscopic aspects in HSV-1 esophagitis (10,11,14,19). These findings require confirmation by histological examination completed with immunohistochemical staining of the biopsy specimens from the ulcer edges, which still remains the "gold standard" for HSV-1 esophagitis diagnosis (13,14,19). Virological diagnosis has been reported to optimize the diagnostic sensitivity of HSV-1 esophagitis (2,16,19). However, it is not systematically performed and is restricted to viral culture or to qualitative PCR assay from esophageal biopsy speci...

show abstract

Section: Discussionmentioning

confidence: 99%

“…HSV-1 esophagitis is well documented in immunocompromised patients, whereas this clinical entity is rare in immunocompetent patients (2,4,5,9). HSV-1 esophagitis may represent a primary infection in particular in the immunocompetent host but is commonly due to a reactivation of a latent infection in the immunocompromised host (7).…”

mentioning

confidence: 99%

Virological Diagnosis of Herpes Simplex Virus 1 Esophagitis by Quantitative Real-Time PCR Assay

et al. 2012

View full text Add to dashboard Cite

show abstract

“…While in immunocompromised patients it is usually secondary to virus reactivation, in immunocompetent subjects is probably due to local extension of the virus from an orolabial or pharyngeal source (1).…”

Section: Herpetic Esophagitis In Immunocompetent Individualsmentioning

confidence: 99%

“…However, the infection in immunocompetent patients is an uncommon condition rarely reported in the literature and most often affecting young adults (1).…”

Section: Introductionmentioning

confidence: 99%

Herpetic esophagitis: a case report on an immunocompetent adolescent

Riva

Muñoz-Navas

Rodríguez–Lago

et al. 2012

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

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.

show abstract

“…2 One of the well-known complications of immunosuppression is herpes simplex esophagitis (HSE) and it is rarely found in immunocompetent patients; which is, in this case, considered a self-limiting disease and rarely necrotic and diffuse. 3,4 For patients with typical symptoms of esophagitis with no clear cause, specially if the ulcers involve distal or mild esophagus, HSE should be suspected and investigated even in immunocompetent patients regardless of the age or gender. Antiviral treatment is established for immunosuppressed patients and need more evidence for immunocompetent patients.…”

Section: Imaging In Internal Medicinementioning

confidence: 99%

Herpes simplex esophagitis

et al. 2017

View full text Add to dashboard Cite

One of the well-known complications of immunosuppression is herpes simplex esophagitis and it is rarely found in immunocompetent patients. We present a case of a 75-year-old female known case of diabetes mellitus, hypertension and dyslipidemia with two-month history of dysphagia and odynophagia to solid mainly and cough tinged with blood. On esophagogastroduodenoscopy there was right side of oropharynx ulcer, edema and focal erythema with compression on the esophageal entrance. Biopsy confirmed esophagitis and findings characteristic of herpes simplex virus infection. After the diagnosis was made, the patient was treated with prednisone for 10 days and famciclovir for 14 days and showed significant improvement in a period of nearly 2 weeks. We recommend antiviral treatment even for immunocompetent patients for the clear acceleration of the recovery time and prevention of possible complications.

show abstract

Herpes esophagitis: a comprehensive review

Cited by 37 publications

References 119 publications

Virological Diagnosis of Herpes Simplex Virus 1 Esophagitis by Quantitative Real-Time PCR Assay

Virological Diagnosis of Herpes Simplex Virus 1 Esophagitis by Quantitative Real-Time PCR Assay

Herpetic esophagitis: a case report on an immunocompetent adolescent

Herpes simplex esophagitis

Contact Info

Product

Resources

About