Herpes esophagitis in immunocompetent adults: report of two cases and review of the literature.

This article describes two cases of esophagitis in immunocompetent adults associated with herpes simplex virus type 1 (HSV-1) infection. One case presented with pharyngitis and the other with whitlow. A review of the literature revealed 21 other cases in immunocompetent adults; and, of these 21 patients, odynophagia was noted in 19, nine experienced fever, and oral lesions were found in five of these individuals. Barium swallow was positive in 8 of 20 patients tested, whereas esophagoscopy showed ulcers in 17 of the 20 cases. Specimens obtained during esophagoscopy revealed viral inclusions in 13 of the 20 patients tested, and viral cultures were positive in 11 of the 15 patients tested. Although upper gastrointestinal hemorrhage occurred in one patient, symptoms generally resolved within a few weeks whether or not acyclovir was administered.