Herpes esophagitis in an otherwise healthy patient

DeGaeta, Linda; Levine, Marc S.; Guglielmi, Gwen E.; Raffensperger, Edward C.; Laufer, Igor

doi:10.2214/ajr.144.6.1205

Cited by 20 publications

(8 citation statements)

References 3 publications

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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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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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“…Differential Diagnosis.-The differential diagnosis for small superficial erosions seen on a barium esophagram includes herpes esophagitis and Crohn esophagitis (3,7,8). Herpes esophagitis is predominately caused by herpes simplex virus type 1 and most commonly occurs in immunocom-Because of the route of administration of most medications (ie, oral) and the mechanisms of absorption and metabolism, the gastrointestinal, hepatobiliary, and pancreatic systems are highly susceptible to drug-induced injury.…”

Section: Ulcer or Esophagitismentioning

confidence: 99%

“…An area of confluent erosions may mimic findings of malignancy, particularly superficial spreading esophageal carcinoma, of which there are several subtypes. The plaquelike and flat subtypes in particular can be difficult to differentiate from promised patients, such as patients with human immunodeficiency virus (HIV), organ transplant recipients, and patients undergoing chemotherapy, but it can also occur in immunocompetent patients (8). The imaging appearance is similar to that of pill esophagitis: small punched-out ulcers with intervening normal tissue (7,8).…”

Section: Teaching Pointsmentioning

confidence: 99%

Imaging of Drug-induced Complications in the Gastrointestinal System

McGettigan¹,

Menias²,

Gao³

et al. 2016

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Drug-induced injury commonly affects the gastrointestinal and hepatobiliary systems because of the mechanisms of absorption and metabolism. In pill esophagitis, injury is frequently related to direct contact with the esophageal mucosa, resulting in small superficial ulcers in the mid esophagus. Nonsteroidal anti-inflammatory drugs can lead to gastrointestinal tract ulcers and small bowel mucosal diaphragms (thin weblike strictures). Injury to the pancreatic and hepatobiliary systems can manifest as pancreatitis, acute or chronic hepatitis, cholestasis, or steatosis and steatohepatitis (which may progress to cirrhosis). Various drugs may also insult the hepatic vasculature, resulting in Budd-Chiari and sinusoidal obstructive syndromes. Focal lesions such as hepatic adenomas may develop after use of oral contraceptives or anabolic steroids. Ultrasonography, computed tomography, and magnetic resonance imaging can aid in diagnosis of drug-induced injuries and often are necessary to exclude other causes.

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“…HE may occur in immunocompetent patients [15,29,47–68]. In such cases, HE is similar to that occurring in immunocompromised patients, but is rarely diffuse and necrotic [55].…”

Section: Populations At Riskmentioning

confidence: 99%