Case Report
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World J Gastroenterol. May 21, 2007; 13(19): 2756-2757
Published online May 21, 2007. doi: 10.3748/wjg.v13.i19.2756
A rare cause of dysphagia: Herpes simplex esophagitis
Bee Lee, Grant Caddy
Bee Lee, Grant Caddy, Department of Gastroenterology, Ulster Hospital, United Kingdom
Author contributions: All authors contributed equally to the work.
Correspondence to: Bee Lee, Department of Gastroenterology, Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast BT16 1RH, United Kingdom. bee9669@yahoo.com
Telephone: +44-2890-567930 Fax: +44-2890-564785
Received: December 12, 2006
Revised: December 20, 2006
Accepted: January 4, 2007
Published online: May 21, 2007
Abstract

Herpes simplex esophagitis (HSE) is well documented in immunosuppressed patients. However, it is rare in the immunocompetent host. We present a case of HSE in a 21 year-old healthy lady who was admitted to our unit with dysphagia, odynophagia and chest pain. Clinical examination revealed mild epigastric tenderness and admission bloods including full blood picture, electrolytes and inflammatory markers were normal. She underwent an esophagogastroduodenoscopy (EGD) which revealed severe exudative, well-circumscribed ulcerations in her distal esophagus. Biopsies confirmed severe esophagitis with acute ulceration and subsequent polymerase chain reaction (PCR) confirmed herpes simplex virus (HSV) type 1. Subsequent assessment failed to identify an immune disorder. HSE should be suspected when faced with characteristic endoscopic findings, even if the patient is immunocompetent. When the diagnosis of HSE is confirmed, an immune deficiency should be sought.

Keywords: Herpes simplex; Esophagitis; Immuno-competent