Herpetic esophagitis in a 7-year-old immunocompetent patient
| Authors | |
|---|---|
| Year of publication | 2020 |
| Type | Article in Periodical |
| Magazine / Source | Gastroenterologie a Hepatologie |
| MU Faculty or unit | |
| 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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