Sequential infection by herpes simplex virus, Candida species, and Cytomegalovirus species in esophagus

A 63-year-old man presented with odynophagia and retrosternal pain. Previously, prednisolone and cyclophosphamide were administered for severe interstitial pneumonia. The first EGD showed diffuse maplike erosions with exfoliation of the epithelium in the distal esophagus (A). Histologic analysis revealed multinucleated cells with ground-glass nuclei (B, arrowheads). His serum herpes simplex virus –immunoglobulin-M level was elevated to 4.49 (antibody index). Acyclovir was administered for herpes simplex virus–induced esophagitis, and the symptoms improved.

Source: Gastrointestinal Endoscopy - April 13, 2019 Category: Gastroenterology Authors: Takuto Yoshioka, Munehiro Ikeda, Naoki Kanda Tags: At the focal point Source Type: research