HSV Esophagitis in an Immunocompetent 17-Year-Old

Area of Science:

• Infectious Diseases
• Gastroenterology
• Virology

Background:

• Herpes Simplex Virus (HSV) esophagitis is an uncommon infection, typically affecting immunocompromised individuals.
• HSV esophagitis in immunocompetent patients is rarely documented, making case reports crucial for understanding.
• This report focuses on a healthy adolescent male to highlight atypical presentations and management.

Observation:

• A previously healthy 17-year-old male presented with fever, odynophagia, lethargy, and emesis.
• Initial investigations revealed thrombocytopenia, electrolyte imbalances, and elevated liver enzymes.
• Diagnostic tests for other infections were negative, but HSV-1 PCR was positive.

Findings:

• Upper endoscopy showed esophageal friability, erythema, exudates, and duodenopathy.
• The patient was diagnosed with Herpes Simplex Virus esophagitis.
• Treatment with intravenous to oral acyclovir resulted in rapid symptom resolution.

Implications:

• This case underscores the importance of considering HSV esophagitis even in immunocompetent patients presenting with severe esophagitis symptoms.
• Early diagnosis and prompt antiviral treatment with acyclovir are critical for favorable outcomes.
• Further research into HSV esophagitis in diverse patient populations may improve clinical guidelines.