Prednisolone
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Prednisolone Herpes simplex oesophagitis: case report
A 72-year-old woman developed herpes simplex oesophagitis during treatment with prednisolone for lymphoma. The woman, who had lymphoma, presented to emergency department with epigastric pain, which started 3 days prior. Her medical history was significant for ischaemic stroke, vertebral compression fracture in T12 and hypertension. She had no history of oral herpes. She had received unspecified chemotherapy and radiotherapy for lymphoma 6 years prior to the presentation. She had been receiving prednisolone [dosage and route not stated] for lymphoma. On presentation, her body temperature was 37.5°C, BP 100/70mm Hg, pulse rate 100 /Rog and oxygen saturation 99%. Physical examination revealed she was oriented, conscious and in good condition. Her abdominal examination showed epigastric tenderness. Murphy sign was negative. Laboratory tests revealed hemoglobin 11.3 g/dl, RBC count 4.63 cell/µl, hematocrit 38.7, WBC count 14,800 cell/µL, CRP 2 mg/L, platelets 314,000 cell/µL, creatinine 1.4 mg/dL, ALT 12 U/L, urea 67 mg/dL, ALP 71 U/L and amylase 160 U/L. Ultrasonography showed no abnormal findings. Upper endoscopy showed multiple rounded ulcers in the lower oesophagus. A biopsy revealed fragments of squamous mucosa with massive eosinophilic and neutrophilic exocytosis, multinucleation and enlarged nuclei. There were no herpetic lesions in pharynx, oral cavity, middle and upper oesophagus. Based on the findings, a diagnosis of herpes simplex oesophagitis secondary to the prednisolone use was made [duration of treatment to reaction onset not stated]. The woman was treated with unspecified proton pump inhibitors and fluids. Then, she applied valaciclovir for 2 weeks. Her symptoms started improving after 3 days of treatment. After 10 days, she had no symptoms. Antaki N, et al. Epigastric pain associated with herpes esophagitis: case report. BMC Infectious Diseases 20: 754, No. 1, 14 Oct 2020. Available from: URL: http:// doi.org/10.1186/s12879-020-05487-5
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Reactions 5 Dec 2020 No. 1833
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