Esophageal Cytomegalovirus and Herpes Simplex Virus Co-infection in an Immunocompetent Patient: A Case Report

Abstract

Infectious esophagitis is a rare disease that usually affects immunocompromised patients. Diagnosis is made by upper endoscopy showing esophagitis and confirmed by histological examination and sometimes PCR on biopsies. We present a case of esophageal cytomegalovirus (CMV) and herpes simplex virus (HSV) co-infection in an immunocompetent patient. The patient is a 50-year-old male with no past history of medical importance. He presented to our department with a recent onset of dysphagia, a fever of 40°C, and chills. Upper endoscopy revealed an erythematous esophageal mucosa and circumferential and confluent superficial ulcers bleeding spontaneously, located mostly in the lower 1/3 of the esophageous. PCR for CMV and HSV on esophageal biopsies was positive, confirming the diagnosis. Primary immune deficiency was excluded. The Human Immunodeficiency Virus (HIV) test was negative. He was treated with ganciclovir and showed clinical improvement. Repeat upper endoscopy after hospital discharge showed complete healing of the esophageal mucosa.