Herpetic esophagitis in a 7-year-old immunocompetent patient

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Authors

JABANDŽIEV Petr JOUZA Martin PECL Jakub URÍK Milan PAPEŽ Jan PINKASOVÁ Tereza SLABÁ Kateřina TRNA Jan KYCLOVÁ Jitka VACULOVÁ Jitka KUNOVSKÝ Lumír

Year of publication 2020
Type Article in Periodical
Magazine / Source Gastroenterologie a Hepatologie
MU Faculty or unit

Faculty of Medicine

Citation
Web http://www.csgh.info/en/article/herpetic-esophagitis-in-a-7-year-old-immunocompetent-patient-11141
Doi http://dx.doi.org/10.14735/amgh2020233
Keywords herpetic esophagitis; children; acyklovir; endoscopy
Description Herpetic esophagitis is a disease dia­gnosed especially in immunocompromised patients. Although the disease is rare in immunocompetent individuals, the dia­gnosis should be considered in the presence of its acute triad of clinical symptoms – odynophagia, chest pain, and fever of unknown origin. Herpes simplex virus type 1 (HSV1) is the most common causative agent. In the majority of cases, the disease develops by re-activation of latent HSV1 infection or, rather rarely, by primo-infection. The basis of dia­gnosis is endoscopic examination of the esophagus with bio­psy and direct detection of the virus in the bio­ptic sample. In immunocompromised patients, treatment with acyclovir, which is the first-line virostatic in this indication, is always indicated. In immunocompetent patients, this is a self-limiting disease, where in most cases merely symptomatic treatment is sufficient. This case report describes an immunocompetent patient with a suddenly occurring typical triad of symptoms caused by herpetic esophagitis. The dia­gnosis was confirmed by the presence of viral DNA as determined by polymerase chain reaction from a sample taken during endoscopic examination. Due to the more severe course of the disease, the patient was treated with acyclovir and the general condition and local endoscopic findings then quickly improved.
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