Herpetic esophagitis in healthy young adult

Herpetic esophagitis (HE) is common in immunocompromised patients but rarely reported in healthy young adults. A 28-year-old healthy male patient visited our clinic with a chief complaint of chest pain. An esophagogastroduodenoscopy revealed widely spread superficial multiple ulcers in the middle to the distal esophagus, and repeated biopsies from the ulcer were performed but revealed inconsistent findings with HE. Thus, he was clinically diagnosed with HE based on endoscopic findings and serologic tests of immunoglobulin M (IgM)/immunoglobulin G (IgG) for herpes simplex virus. He responded to valacyclovir, and all esophageal ulcers had scarred.