Herpes oesophagitis is one of the infectious oesophagitis that usually affects immunocompromised patients.
It occurs as an opportunistic infection in immunocompromised patients, particularly those with AIDS. It has also been described in immunocompetent individuals 3.
The aetiological agent is the herpes simplex virus (HSV), which is a double-stranded DNA virus classified into two subtypes: HSV-1 and HSV-2.
It can be a consequence of viraemia, reactivation of HSV, or even a direct spread of the virus to oesophageal mucosa from the vagus nerve in immunocompromised patients. The definitive diagnosis is made with endoscopic biopsy 1.
On double contrast studies, it manifests as multiple small (<1cm) punctate or linear ulcers with surrounding radiolucent halo.
Treatment and prognosis
It is considered a self-limited condition and expected to resolve within two weeks, only managed with symptomatic treatment 1.
- oesophageal perforation 1,2
- gastrointestinal bleeding
Other causes of infectious oesophagitis:
- oesophageal dysmotility
- oesophageal tumours
- benign oesophageal neoplasms
- malignant oesophageal neoplasms
- gastro-oesophageal reflux disease
- oesophageal stricture
- 1. Eymard D, Martin L, Doummar G et-al. Herpes simplex esophagitis in immunocompetent hosts. Can J Infect Dis. 2012;8 (6): 351-3. Free text at pubmed - Pubmed citation
- 2. Cronstedt JL, Bouchama A, Hainau B et-al. Spontaneous esophageal perforation in herpes simplex esophagitis. Am. J. Gastroenterol. 1992;87 (1): 124-7. Pubmed citation
- 3. Levine MS, Rubesin SE. Diseases of the esophagus: diagnosis with esophagography. Radiology. 2005;237 (2): 414-27. Radiology (full text) - doi:10.1148/radiol.2372050199 - Pubmed citation