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Herpes simplex esophagitis in immunocompetent individuals.

U Ashar-Sampat1, D Desai, A Bhaduri

  • 1Department of Medicine, P D Hinduja National Hospital and Medical Research Center, Mumbai.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|January 31, 2002
PubMed
Summary

Herpes simplex esophagitis, typically seen in immunocompromised patients, can also affect immunocompetent individuals. This study reports cases in both immunocompetent and corticosteroid-treated patients, with varied outcomes.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Virology

Background:

  • Herpes simplex esophagitis (HSE) is predominantly observed in immunocompromised populations.
  • Understanding HSE in diverse patient groups is crucial for accurate diagnosis and management.

Observation:

  • This report details four cases of herpes simplex esophagitis.
  • Two cases occurred in immunocompetent individuals presenting with distinct symptoms: retrosternal pain and diarrhea, or dysphagia and fever.
  • Two cases involved patients with obstructive airway disease on corticosteroid therapy.

Findings:

  • The two immunocompetent patients experienced different outcomes without antiviral treatment; one was lost to follow-up, while the other remained asymptomatic for two years.
  • The two patients with obstructive airway disease and corticosteroid use received acyclovir therapy.

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Implications:

  • Herpes simplex esophagitis should be considered in the differential diagnosis of esophageal symptoms, even in immunocompetent individuals.
  • Corticosteroid therapy may increase the risk of HSE in patients with underlying conditions like obstructive airway disease.
  • Prompt diagnosis and appropriate antiviral treatment (e.g., acyclovir) are essential for managing HSE, particularly in at-risk populations.