Herpes simplex esophagitis after trigeminal nerve surgery.

While being followed for reactivation of latent herpes virus infection after surgery for tic douloureux, a patient developed herpetic esophagitis. The patient was not an immunocompromised host in the usual sense of the term. Two possible interrelated, predisposing conditions were identified: (1) oropharyngeal shedding of herpes simplex virus, which frequently follows surgery on the trigeminal nerve, in association with (2) esophageal intubation and presumed mucosal trauma. Symptoms began within 24 hr after virus excretion in the mouth was documented. Esophageal lesions were present and herpes simplex virus was recovered from the biopsy 6 days after symptoms developed. Herpetic esophagitis should be considered when patients developed odynophagia after esophageal instrumentation in association with possible reactivation of latent herpes infection.