# Herpes Simplex Esophagitis in an Immunocompetent Adult

## TL;DR

This paper reports a rare case of herpes simplex esophagitis in a healthy 19-year-old woman and discusses its diagnosis and treatment.

## Contribution

The novelty lies in presenting a rare case of HSE in an immunocompetent adult and confirming the diagnosis through histopathology and HSV-1 PCR.

## Key findings

- HSE was diagnosed in an immunocompetent patient using histopathology and HSV-1 PCR of an esophageal biopsy.
- The patient showed clinical improvement after treatment with acyclovir.
- HSE in immunocompetent individuals is rare but diagnosable with a combination of clinical history, endoscopy, and molecular testing.

## Abstract

Herpes simplex esophagitis (HSE) caused by herpes simplex virus (HSV) infection is a well-recognized opportunistic infection in an immunocompromised host. HSE in immunocompetent patients is an uncommon clinical event; however, when it does occur, it is generally a self-limiting condition. This case involves an immunocompetent 19-year-old female patient who presented to the emergency department (ED) with a three-day history of nausea, vomiting, and inability to tolerate oral intake. The diagnosis of HSE was made via histopathological analysis and HSV-1 polymerase chain reaction (PCR) of an esophageal biopsy. The patient clinically improved on acyclovir. HSE in the immunocompetent patient is a rare clinical entity. A combination of history, upper endoscopy, histopathology, and HSV-PCR is used to diagnose HSE. Antiviral therapy with acyclovir may reduce the severity and duration of infection.