Pape Magdalini, Mandraveli Kalliopi, Sidiropoulos Ioannis, Koliouskas Dimitrios, Alexiou-Daniel Stella, Frantzidou Filanthi
J Med Case Rep. 2009 Jun 29;3:7314. doi: 10.4076/1752-1947-3-7314.
Epstein-Barr virus esophagitis in an immunocompetent host is a rare entity. It represents either primary infection or reactivation and is usually characterized by acute onset and extensive ulcerative involvement of the upper and middle third of the esophagus.
A case of Epstein-Barr virus esophagitis in a 27-year-old woman with no immunosuppressive factors, and having gastrointestinal symptoms is reported here. Using real-time polymerase chain reaction, biopsy and blood specimens were tested for candida and herpes viruses. Epstein-Barr virus DNA was detected in tissue samples. The patient was treated with acyclovir with resolution of the symptomatology.
The prevalence of esophagitis remains undefined in both immunodeficient and immunocompetent individuals and should be taken into consideration in a patient presenting with esophageal symptoms. This case report stresses the role of Epstein-Barr virus infection in the pathogenesis of esophagitis, a rare condition in an immunocompetent host. In this setting, active infection may represent a primary infection or reactivation. Histopathological examination alone may miss the diagnosis, while polymerase chain reaction techniques optimize the diagnostic sensitivity, establish a diagnosis, and lead to an appropriate therapy.
免疫功能正常宿主中的爱泼斯坦-巴尔病毒食管炎是一种罕见疾病。它代表原发性感染或再激活，通常表现为急性起病，食管上三分之二和中三分之一广泛的溃疡性病变。
本文报告了一例27岁无免疫抑制因素且有胃肠道症状的女性患爱泼斯坦-巴尔病毒食管炎的病例。使用实时聚合酶链反应对活检组织和血液标本进行念珠菌和疱疹病毒检测。在组织样本中检测到爱泼斯坦-巴尔病毒DNA。患者接受阿昔洛韦治疗后症状缓解。
免疫缺陷和免疫功能正常个体中食管炎的患病率仍不明确，出现食管症状的患者应考虑到这一点。本病例报告强调了爱泼斯坦-巴尔病毒感染在食管炎发病机制中的作用，这在免疫功能正常宿主中是一种罕见疾病。在这种情况下，活动性感染可能代表原发性感染或再激活。仅靠组织病理学检查可能会漏诊，而聚合酶链反应技术可提高诊断敏感性、确诊并指导适当治疗。
