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Herpetic esophagitis: a case report on an immunocompetent adolescent
Susana de-la-Riva1, Miguel Muñoz-Navas, Iago Rodríguez-Lago
1Department of Gastroenterology, Endoscopy Unit, Clínica Universidad de Navarra. Pamplona, Spain. Sdelariva@unav.es
Revista Espanola De Enfermedades Digestivas
|April 28, 2012
Summary
Herpetic esophagitis, a rare condition in immunocompetent individuals, presents with severe throat pain, heartburn, and fever. Diagnosis involves endoscopy and viral culture, though treatment in healthy patients remains debated.
Area of Science:
- Gastroenterology
- Virology
- Infectious Diseases
Background:
- Herpetic esophagitis is uncommon in immunocompetent individuals, often presenting as a triad of odynophagia, heartburn, and fever.
- It can result from primary infection or reactivation, with Herpes Simplex Virus type 1 being the most frequent cause.
Observation:
- This case highlights acute herpetic esophagitis in an immunocompetent host with severe upper gastrointestinal symptoms and flu-like illness.
- Endoscopic examination revealed significant esophageal mucosal involvement in the lower third.
Findings:
- Upper endoscopy is crucial for diagnosing suspected herpetic esophagitis, enabling biopsies and viral cultures for definitive diagnosis.
- Symptom severity correlates with the extent of esophageal inflammation.
Implications:
- While acyclovir is standard for immunocompromised patients, its use in immunocompetent individuals with herpetic esophagitis is controversial due to the self-limiting nature and low complication rate.
- This case underscores the importance of clinical suspicion for herpetic esophagitis in immunocompetent patients presenting with characteristic symptoms.
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