Epigastric pain associated with herpes esophagitis: case report
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CASE REPORT
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Epigastric pain associated with herpes esophagitis: case report Nabil Antaki1, Ziad Aljarad2*, Howayda Dabbas3, Walid Haddad4, M. Amin Akil4 and Ahmad Sankari Tarabishi4
Abstract Background: Herpes esophagitis is uncommon disease caused by Herpes simplex virus (HSV). While the disease most often occurs in immunocompromised patients, including post-chemotherapy, immunosuppression with organ transplants, and in AIDS, Herpes esophagitis can also occur in immunocompetent individuals. Case presentation: We report a case of herpes esophagitis in a 72 year- old woman who was presumed to be immunocompromised following prolonged radiotherapy and chemotherapy for lymphoma. Her main symptom was epigastric pain. Upper endoscopy showed multiple rounded ulcers in lower esophagus. The diagnosis was confirmed histologically by multiple biopsies. The patient received Valacyclovir for 2 weeks and started to get better within 3 days of treatment. Conclusion: Although there are few published cases of Herpes esophagitis disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing immunocompromised patients presenting with non-specific abdominal symptoms. Keywords: Herpes, Esophagitis, Case report
Background Although herpes infection is common even in immunocompetent Individuals, herpes simplex esophagitis (HSE) is uncommon. Historically, most cases of Herpes esophagitis were diagnosed at postmortem examination of immunocompromised or severely debilitated patients [1–3]. However, with the development of diagnostic procedures, many well-documented cases of herpes esophagitis have also reported in healthy patients at risk [4, 5]. What makes Herpes esophagitis clinically important is that herpes simplex esophagitis can overlap with reflux symptoms, leaving many HSE patients undiagnosed [6]. The symptoms previously published in the literature are acute onset of esophageal complaints such as chest * Correspondence: [email protected] 2 Department of Internal Medicine, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria Full list of author information is available at the end of the article
Pain, odynophagia, dysphagia for both solids and liquids, heartburn and/or vomiting [7], whereas no specific symptoms were presented in 26% of patients [8]. We describe here a case of immunocompromised woman due to chemotherapy and radiotherapy for lymphoma, presented with non specific symptoms like epigastric pain, not associated with diarrhea or vomiting and not related to food. Her endoscopic and histological findings were consistent with HSE.
Case presentation A 72 year-old women presented to Emergency complaining of epigastric pain that started 3 days ago, the pain was an isolated upper gastrointestinal symptom, not associated with diarrhea or vomiting and not related to food or any other triggers, this episode of pain was not the first one. The patient suffers from hypertension, ischemic stroke, a treate
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