Herpes Simplex Virus Esophagitis in an Immunocompetent Hepatitis B Carier: Report of a Case

Herpes simplex esophagitis is common in the immunocompromised hosts including those patients with malignancies, immunotherapy, and acquired immunodeficiency syndrome (AIDS), but rarely in immunocompetent patient. They often presented with triad of fever, chest pain, and odynophagia. Herpes simpex esophagitis had been reported in patients with alcoholic liver disease, but they were associated with severe liver disease with some extent of immunodeficiency. The risk of disseminated herpes simplex virus infection is increased in such patients, and effective anti-viral treatment was suggested. We report a 48 years old man, he is a hepatitis B carrier with otherwise healthy presented with odynophagia. Esophagoscopy revealed multiple punched-out ulcers with white membrane coating at 35 cm from the incisor. Histopathology showed multinucleated giant cells and ”Cowdry type A” intranuclear inclusions. He received oral sucralfate gel only. Follow up esophagoscopy 8 weeks later showed complete resolution of esophageal ulcers.