PRIMARY HERPES SIMPLEX VIRUS INFECTION CAUSED HERPES ESOPHAGITIS IN A HEALTHY CHILD

DOI
  • MATSUEDA Mayu
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • TAKAHASHI Sakuma
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • INABA Tomoki
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • COLVIN Mariko
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • AOYAMA Yuuki
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • KAGAWA Tomo
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • KAWAI Yuusuke
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • ISHIKAWA Shigenao
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • WATO Masaki
    Department of Gastroenterology, Kagawa Prefectural Central Hospital.
  • ANDO Midori
    Department of Diagnostic Pathology, Kagawa Prefectural Central Hospital.

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Other Title
  • 健常小児に発症した単純ヘルペスウイルス初感染によるヘルペス食道炎の１例

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Abstract

<p>A healthy 13-year-old male with fever, postprandial chest pain and anorexia was diagnosed with bronchitis by his family doctor and received antibiotic therapy for seven days. The symptoms did not improve, and he was referred to our hospital. Endoscopy revealed a small erosion and a sharply demarcated, punched-out, circular ulcer in the middle esophagus, and many longitudinal confluent ulcers in the distal esophagus. Histological examination of the esophageal biopsy specimens showed inflammation and giant cells with nuclear enlargement and ground-glass nuclei in epithelial cells. Immunohistochemical staining for herpes simplex virus (HSV) antibody was positive. Serologically, he was positive for anti-HSV immunoglobulin (Ig) M and negative for anti-HSV IgG at the time of the first visit. However, anti-HSV-IgG showed seroconversion during the recovery period. We diagnosed herpes esophagitis caused by primary HSV infection in this healthy child. Herpes esophagitis by primary HSV infection is rare, because it is considered that herpes esophagitis is usually caused by recurrent HSV infection in an immunocompromised or debilitated host. After administration of valacyclovir for 7 days, his symptoms and endoscopic findings promptly improved.</p>

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