Herpetic Esophagitis in Immunocompetent Medical Student

Esophagitis caused by herpes simplex virus (HSV) is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV); it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient. 1. Introduction Esophagitis caused by herpes simplex virus (HSV) is frequently documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV). This condition can also occur as a primary infection in individuals taking immunosuppressive drugs and it is therefore considered as an opportunistic disease [1]. Cases of herpetic esophagitis in young immunocompetent individuals are rare in the literature; reports in which the patient is a healthcare student are even more unusual. Although herpetic esophagitis is rare in immunocompetent individuals, it should be considered as a diagnostic hypothesis for clinical conditions characterized by acute odynophagia and retrosternal pain without other obvious causes and ulcers, evidenced endoscopically in the mid-distal esophagus [1]. Thus, the aim of this case report is to describe esophagitis caused by herpes simplex virus in an immunocompetent, healthy, female medical student. 2. Case Report A 22-year-old, white, single female medical student reported pain when swallowing. The pain manifested four days prior to presentation and began with a burning epigastric pain and intense heartburn. The patient was self-medicated with omeprazole and domperidone without success. After approximately 12 hours, there was a change in the pattern of pain, which was constrictive and intermittent and was located in the sternal region. The patient developed asthenia, malaise, appetite loss, and a daily fever of up to 38.5°C during the afternoon/early evening. She reported a weight loss of 5？kg over one week with