Koutsoumourakis Anastasios, Gagalis Asterios, Fotoulaki Maria, Stafylidou Maria
First Department of Internal Medicine, Papageorgiou Teaching Hospital, Thessaloniki, Greece.
Fourth Department of Pediatrics, Papageorgiou Teaching Hospital, Thessaloniki, Greece.
Case Rep Gastroenterol. 2021 Mar 12;15(1):352-358. doi: 10.1159/000513801. eCollection 2021 Jan-Apr.
Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. omeprazole 40 mg two times a day, and acyclovir 5% cream four times a day. After 8 days of admission, the patient was discharged. A follow-up esophagogastroduodenoscopy was performed 7 weeks after discharge, and the results revealed that the esophageal mucosa had a normal appearance. The effect of antiviral treatment against HE remains unknown in these patients. Nevertheless, it is believed to accelerate the healing process in individuals with esophageal mucosal barrier damage. To the best of our knowledge, this case of a female adolescent with an intact immune system is the sixth case of herpes simplex esophagitis to be reported in the literature.
疱疹性食管炎（HE）在免疫功能正常的青少年中较为罕见。然而，它在较年轻个体中通常作为原发性感染出现。在此，我们报告一名16岁女性患者，她有5天发热病史、吞咽痛以及7天的口周疱疹感染史。体格检查发现嘴唇、牙龈和上颚有红斑基底上的成簇疼痛性水疱。此外，食管胃十二指肠镜检查显示远端食管有弥漫性线性溃疡。该患者随后接受了以下治疗：静脉注射阿昔洛韦5mg/kg，每日3次；静脉注射奥美拉唑40mg，每日2次；以及5%阿昔洛韦乳膏，每日4次。入院8天后，患者出院。出院7周后进行了随访食管胃十二指肠镜检查，结果显示食管黏膜外观正常。抗病毒治疗对这些患者中HE的疗效尚不清楚。然而，据信它能加速食管黏膜屏障受损个体的愈合过程。据我们所知，这例免疫系统完好的女性青少年病例是文献中报道的第六例单纯疱疹性食管炎病例。
