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Torpid herpetic esophagitis in immunocompetent patient –  video case report


Authors: P. Vítek 1,2;  I. Mikoviny Kajzrlíková 1;  A. Buriánová 3;  V. Hořava Jr. 4;  P. Širůček 5
Authors‘ workplace: Beskydské Gastrocentrum, Interní oddělení, Nemocnice ve Frýdku- Místku, p.  o. 1;  Lékařská fakulta OU v Ostravě 2;  Interní oddělení, Nemocnice s poliklinikou Havířov, p.  o. 3;  Oddělení patologie, Nemocnice ve Frýdku- Místku, p.  o. 5 Klinika infekčního lékařství LF OU a FN Ostrava 4
Published in: Gastroent Hepatol 2015; 69(3): 201-203
Category: Digestive Endoscopy: Case Report
doi: https://doi.org/10.14735/amgh2015201

Videozáznam si můžete přehrát na: www.csgh.info

Overview

We present a case of a 49-year- old immunocompetent woman with relapsing and prolonged herpes esophagitis that presented with odynophagia and weight loss. Endoscopy revealed esophageal ulcers with typical morphology, other infectious and non-infectious causes of esophagitis were excluded. Acyclovir therapy had only transient effect. Long term valacyclovir therapy led to relief of symptoms, esophageal ulcers healed. Direct detection of HSV with PCR was not successful.

Key words:
esophagitis –  herpes simplex virus –  valacyclovir

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
9. 5. 2015

 Accepted:
16. 5. 2015


Sources

1. McBane RD, Gross JB Jr. Herpes esophagitis: clinical syndrome, endoscopic appearance, and diagnosis in 23 patients. Gastrointest Endosc 1991; 37(6): 600– 603.

2. Ramanathan J, Rammouni M, Baran J Jret al. Herpes simplex virus esophagitis in the immunocompetent host: an overview. Am J Gastroenterol 2000; 95(9): 2171– 2176.

3. Baehr PH, McDonald GB. Esophageal infections: risk factors, presentation, diagnosis, and treatment. Gastroenterology 1994; 106(2): 509– 532.

4. Frobert E, Ooka T, Cortay JC et al. Herpes simplex virus thymidine kinase mutations associated with resistance to acyclovir: a site- directed mutagenesis study. Antimicrob Agents Chemother 2005; 49(3): 1055– 1059.

5. Levin MJ, Bacon TH, Leary JJ. Resistance of herpes simplex virus infections to nucleoside analogues in HIV- infected patients. Clin Infect Dis 2004; 39 (Suppl 5): S248– S257.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery
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