Herpetiform esophagitis: Difference between revisions

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Herpes esophagitis

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+#redirect [[Herpes esophagitis]]
-{{Infobox_Disease |
-  Name           = {{PAGENAME}} |
-  Image          = Herpes esophagitis.JPG |
-  Caption        = Endoscopic image of '''Herpes esophagitis'''|
-  DiseasesDB     = |
-  ICD10          = {{ICD10|B|00|9}} |
-  ICD9           = {{ICD9|054.79}} |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = |
-  eMedicineSubj  = |
-  eMedicineTopic = |
-  MeshID         = |
-}}
-'''Herpes esophagitis''' is a viral infection of the [[esophagus]] caused by''[[Herpes simplex virus]]''.  While the disease most often occurs in immunocompromised patients, including post-[[chemotherapy]], immunosuppression with organ transplants<ref>G. G. Miller; J. S. Dummer Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone. American Journal of Transplantation. 2007;7(4):741-747.</ref> and in [[AIDS]].<ref>McBane RD; Gross, JB Jr. Herpes esophagitis: Clinical syndrome, endoscopic appearance, and diagnosis in 23 patients. Gastrointest Endosc 1991; 37:600.</ref> herpes esophagitis can also occur in immunocompetent individuals.<ref>Kato S; Yamamoto R; Yoshimitsu S; Shimazaki K; Ogawa S; Itoh K; Miura S Herpes simplex esophagitis in the immunocompetent host. Dis Esophagus.  2005; 18(5):340-4</ref>  It is also known as '''herpes esophagitis''' or '''herpetiform esophagitis'''.
-==Clinical presentation==
-Patients with herpes esophagitis experience [[odynophagia]], or painful swallowing and [[dysphagia]].  Other symptoms can include [[Esophageal food bolus obstruction]]<ref>Marshall, JB, Smart JR, 3d, Elmer, C, et al. Herpes esophagitis causing an unsuspected esophageal food bolus impaction in an institutionalized patient [letter]. J Clin Gastroenterol 1992; 15:179.</ref>|food impaction, [[hiccups]]<ref>Mulhall, BP, Nelson, B, Rogers, L, Wong, RK. Herpetic esophagitis and intractable hiccups (singultus) in an immunocompetent patient. Gastrointest Endosc 2003; 57:796.</ref>, weight loss, fever,<ref>Kato S; Yamamoto R; Yoshimitsu S; Shimazaki K; Ogawa S; Itoh K; Miura S Herpes simplex esophagitis in the immunocompetent host. Dis Esophagus.  2005; 18(5):340-4</ref> and on rare occasions [[upper gastrointestinal bleeding]] as noted in the image above<ref>Takeno M; Adachi H; Nakahama T Herpes esophagitis presenting with upper gastrointestinal bleeding: report of a case Nippon Shokakibyo Gakkai Zasshi.  2002; 99(8):935-40 </ref> and [[tracheoesophageal fistula]]<ref>Obrecht, WF Jr, Richter, JE, Olympio, GA, Gelfand, DW. Tracheoesophageal fistula: A serious complication of infectious esophagitis. Gastroenterology 1984; 87:1174.</ref>. Frequently one can see herpetiform lesions in the mouth and lips.
-==Diagnostic testing==
-Upper Endoscopy often reveals ulcers throughout the esophagus with intervening normal-appearing mucosa. In severe cases the ulcers can coalesce and on rare occasions have a black appearance known as black esophagus.<ref>Nagri S; Hwang R; Anand S; Kurz J Herpes simplex esophagitis presenting as acute necrotizing esophagitis ("black esophagus") in an immunocompetent patient. Endoscopy.  2007; 39 Suppl 1:E169</ref> While the diagnosis of herpes esophagitis can be inferred clinically it can only be accurately diagnosed through endoscopically obtained biopsies with microscopic evaluation by a pathologist finding the appropriate inclusion bodies and diagnostic immunochemical staining.<ref>William E. Bennett, Jr; Phillip I. Tarr Enteric Infections and Diagnostic Testing. Curr Opin Gastroenterol. 2009;25(1):1-7.</ref>
-==Therapy==
-Antivirals such as [[acyclovir]] 400 mg by mouth 5 times daily for 14 to 21 days, [[famciclovir]] 500 mg 3 times daily for 14 to 21 days and [[valacyclovir]] 1 gram 3 times daily for 14 to 21 days may be used. Intravenous [[acyclovir]] 5 mg/kg IV every eight hours for 7 to 14 days is reserved for individuals who cannot swallow due to the odynophagia, individuals with other systemic manifestations of herpes or severely immunocompromised individuals.
-==Prevention==
-Herpes simplex virus is commonly found in humans, yet uncommonly results in systemic manifestations. Suppression of HIV virus with antiretroviral medications, careful monitoring of immunosuppressive medications are important means of prevention. Antiviral prophylaxis such as daily [[acyclovir]] in immunocompromised individuals may be considered.
-==References==
-<references/>
-Itoh T; Takahashi T; Kusaka K; Kawaura K; Nakagawa Y; Yamakawa J; Kanda T Herpes simplex esophagitis from 1307 autopsy cases. J Gastroenterol Hepatol.  2003; 18(12):1407-11.
-Baehr PH; McDonald, GB. Esophageal infections: Risk factors, presentation, diagnosis, and treatment. Gastroenterology 1994; 106:509.
-Lee B; Caddy, G. A rare cause of dysphagia: herpes simplex esophagitis. World J Gastroenterol 2007; 13:2756.
-{{Digestive system diseases}}
-[[Category:Gastroenterology]]
-[[Category:Virus disease]]
-[[simple:Herpes esophagitis]]