Herpes simplex esophagitis in the immunocompetent host.
We report here a case of herpes esophagitis with Mallory-Weiss syndrome in an immunocompetent host. A 26-year-old man was admitted to our hospital because of common cold symptoms and eruptions on the body. On day 2 after hospitalization, the patient showed high-grade fever, odynophagia and hematemesis. Upper gastrointestinal endoscopic examination showed multiple ulcerations throughout the mid- and distal esophagus. Bleeding from a Mallory-Weiss tear was also seen. Follow-up endoscopic examinations showed whitish exudates on day 5. Histological examination of biopsy specimens showed Cowdry type A intranuclear inclusion bodies in epithelial cells. Positive staining of a specific antibody against herpes simplex virus-1 (HSV-1) was seen in the nuclei of esophageal epithelial cells. Primary HSV-1 infection was suspected because ELISA titers of serum IgM antibody against HSV-1 were high and titers of serum IgG antibody against HSV-1 increased from an almost cut-off ratio. A diagnosis of herpes esophagitis in an immunocompetent host was made. Our case is the first report of herpes esophagitis with Mallory-Weiss syndrome in the immunocompetent host. It is important to remind herpes esophagitis in cases of severe odynophagia even in immunocompetent hosts.
Kato
S
S
Fukuoka Japan Self Defense Forces Hospital, Fukuoka, Japan.
Yamamoto
R
R
Yoshimitsu
S
S
Shimazaki
K
K
Ogawa
S
S
Itoh
K
K
Miura
S
S
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D004797:Enzyme-Linked Immunosorbent Assay; D004941:Esophagitis / Q000453:epidemiology / Q000378:metabolism / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000276:immunology; D006801:Humans; D007121:Immunocompetence; D007150:Immunohistochemistry; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000453:epidemiology
D000914:Antibodies, Viral; D002097:C-Reactive Protein