title: Herpes simplex primo-infection in an immunocompetent host with eosinophilic esophagitis.
abstract: Eosinophilic esophagitis and herpes simplex esophagitis are separately well-described entities, but their simultaneous occurrence may pose a special challenge to the clinician, especially regarding the optimal therapeutic approach. The following case report describes a patient with a history of cow's milk and dairy products intolerance, but without an underlying immunologic defect, in whom eosinophilic esophagitis was diagnosed in the course of primary herpes simplex virus 1 (HSV1) infection that clinically presented as herpes labialis and severe esophagitis. The diagnosis was confirmed by a polymerase chain reaction from cytological brush and by immunohistochemical staining that detected the presence of HSV1 DNA in esophageal mucosa, and histologically by persistent eosinophil-predominant inflammation, typical of eosinophilic esophagitis. Despite severe clinical presentation, the HSV1 infection was self-limited. After a directed elimination diet was introduced, the clinical course was favorable, without the need for antiviral therapy.
authors.affiliation: Department of Pediatric Gastroenterology and Hepatology, University Hospital Centre Sestre milosrdnice, Zagreb, Croatia. orjenazf@yahoo.com
authors.forename: Orjena
authors.initials: O
authors.lastname: Žaja Franulović
authors.forename: Tatjana
authors.initials: T
authors.lastname: Lesar
authors.forename: Nikolina
authors.initials: N
authors.lastname: Busic
authors.forename: Goran
authors.initials: G
authors.lastname: Tešović
mesh_terms: D000293:Adolescent; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology; D004947:Esophagus / Q000276:immunology / Q000473:pathology; D005260:Female; D006560:Herpes Labialis / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology; D018259:Herpesvirus 1, Human / Q000235:genetics; D006801:Humans; D007121:Immunocompetence / Q000276:immunology*; D009092:Mucous Membrane / Q000276:immunology / Q000473:pathology; D016133:Polymerase Chain Reaction
chemical_list: D004279:DNA, Viral