Herpes esophagitis is one of the infectious esophagitis that usually affects immunocompromised patients.
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Epidemiology
It occurs as an opportunistic infection in immunocompromised patients, particularly those with AIDS. It has also been described in immunocompetent individuals 3.
Pathology
The etiological 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 viremia, reactivation of HSV, or even a direct spread of the virus to esophageal mucosa from the vagus nerve in immunocompromised patients. The definitive diagnosis is made with endoscopic biopsy 1.
Radiographic features
Fluoroscopy
On double contrast studies, it manifests as multiple small (<1 cm) punctate or linear ulcers with surrounding radiolucent halo. It has a predilection for the middle third of the esophagus 4.
Treatment and prognosis
It is considered a self-limited condition and expected to resolve within two weeks, only managed with symptomatic treatment 1.
Complications
Differential diagnosis
Other causes of infectious esophagitis:
