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Peer-reviewedCC BY-NC-NDACG case reports journal

Herpes Simplex Esophagitis Superimposed on Eosinophilic Esophagitis in an Immunocompetent Patient.

  • L Gramacho Lopes1
  • R Fagundes Dos Anjos Araujo1
  • A Nerves Egidio1
  • Ricardo Castejon Nascimento1
  • Renata Figueiredo Rocha1
  • Rodrigo Albuquerque Carreiro1
  • Ricardo Pereira Mendes1
  1. 1Hospital Madre Teresa, Belo Horizonte, Minas Gerais, Brazil.
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Abstract

Herpes simplex esophagitis (HSE) rarely occurs in immunocompetent patients. Eosinophilic esophagitis (EoE) may predispose to herpes simplex virus superinfection through epithelial barrier disruption. We present an immunocompetent woman with previous EoE managed with dietary modifications without pharmacologic therapy who developed severe odynophagia. Endoscopy showed erosive esophagitis mimicking candidiasis and active EoE, histologically consistent with HSE without eosinophilic inflammation or fungal organisms. Empiric antifungals and corticosteroids were discontinued, and intravenous acyclovir was initiated with rapid improvement. Follow-up endoscopy confirmed complete mucosal healing. This case highlights the diagnostic complexity of HSE complicating EoE and the indispensable role of histopathologic evaluation.

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Cite

BibTeXRIS
BibTeX
@article{lopes2026herpes,
  title = {{Herpes Simplex Esophagitis Superimposed on Eosinophilic Esophagitis in an Immunocompetent Patient.}},
  author = {L Gramacho Lopes and R Fagundes Dos Anjos Araujo and A Nerves Egidio and Ricardo Castejon Nascimento and Renata Figueiredo Rocha and Rodrigo Albuquerque Carreiro and Ricardo Pereira Mendes},
  journal = {ACG case reports journal},
  year = {2026},
  month = oct,
  doi = {10.14309/crj.0000000000002356},
  url = {https://europepmc.org/article/MED/42910384},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Herpes Simplex Esophagitis Superimposed on Eosinophilic Esophagitis in an Immunocompetent Patient.
AU  - L Gramacho Lopes
AU  - R Fagundes Dos Anjos Araujo
AU  - A Nerves Egidio
AU  - Ricardo Castejon Nascimento
AU  - Renata Figueiredo Rocha
AU  - Rodrigo Albuquerque Carreiro
AU  - Ricardo Pereira Mendes
PY  - 2026
DA  - 2026/10/21
JO  - ACG case reports journal
DO  - 10.14309/crj.0000000000002356
UR  - https://europepmc.org/article/MED/42910384
AB  - Herpes simplex esophagitis (HSE) rarely occurs in immunocompetent patients. Eosinophilic esophagitis (EoE) may predispose to herpes simplex virus superinfection through epithelial barrier disruption. We present an immunocompetent woman with previous EoE managed with dietary modifications without pharmacologic therapy who developed severe odynophagia. Endoscopy showed erosive esophagitis mimicking candidiasis and active EoE, histologically consistent with HSE without eosinophilic inflammation or fungal organisms. Empiric antifungals and corticosteroids were discontinued, and intravenous acyclovir was initiated with rapid improvement. Follow-up endoscopy confirmed complete mucosal healing. This case highlights the diagnostic complexity of HSE complicating EoE and the indispensable role of histopathologic evaluation.
SN  - 2326-3253
ER  -