Clinical Images
Esophagitis in the Immunocompetent Host
Darlyn Victor, MD and Jacqueline Fischer, MD
October 28, 2016
A 30-year-old healthy woman was admitted with new-onset odynophagia, dysphagia, and non-exertional retrosternal chest pain. Vital signs were normal. Basic lab tests were within normal reference range. Electrocardiogram, troponin levels, and CT angiography of the chest were unremarkable. The patient denied tobacco, alcohol, illicit drug use, chronic NSAID use, history of gastroesophageal reflux disease or peptic ulcer disease. She underwent evaluation with esophagram (See Figure 1), which demonstrated normal swallowing mechanism without evidence of constricting esophageal lesions. She subsequently underwent esophagogastroduodenoscopy (EGD), which demonstrated multiple satellite erosive lesions with normal-appearing intervening mucosa, extending from the mid-to-distal esophagus (See Figure 2). Histopathologic biopsies demonstrated erosive esophagitis and intranuclear eosinophilic inclusions. Human immunodeficiency virus (HIV) rapid screen and helicobacter pylori results were negative.
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References:
1. Canalejo, C. E., Garcia, D. F., Cabello, N., & Garcia-Martinez, J. Herpes esophagitis in healthy adults and adolescents: report of 3 cases and review of the literature. Medicine (Baltimore) 2010 Jul; 89(4): 204-10
2. Galbraith, J.C., & Shafran, S. D. Herpes simplex esophagitis in the immunocompetent patient: report of four cases and review. Clin Infect Dis. 1992 Apr; 14(4): 894-901
Author bios:
Darlyn Victor, MD, is a third-year Internal Medicine resident at the University of Illinois College of Medicine at Peoria in Peoria, Illinois.
Jacqueline Fischer, MD, is an Associate Clinical Professor and Academic Hospitalist at the University of Illinois College of Medicine at Peoria in Peoria, Illinois.