Herpes simplex virus esophagitis in an immunocompromised patient: case report of an atypical presentation

Gonzalo David Layza-Reyes; Camila Milagros León-Mejía; Eloy Maier Valencia Reyes; José Luis Villalva Luna; Gustavo Quispe-Villegas; Álvaro Bellido-Caparó

doi:10.17843/rpmesp.2025.424.14674

Authors

Gonzalo David Layza-Reyes Universidad Peruana Cayetano Heredia, Lima, Peru https://orcid.org/0009-0001-4663-7918
Camila Milagros León-Mejía Universidad Peruana Cayetano Heredia, Lima, Peru https://orcid.org/0009-0003-5743-7473
Eloy Maier Valencia Reyes Servicio de Gastroenterología, Hospital Cayetano Heredia, Lima, Perú. https://orcid.org/0009-0000-6233-0089
José Luis Villalva Luna Servicio de Gastroenterología, Hospital Cayetano Heredia, Lima, Perú. https://orcid.org/0000-0003-3464-8609
Gustavo Quispe-Villegas Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Perú. https://orcid.org/0000-0001-8833-5072
Álvaro Bellido-Caparó Universidad Peruana Cayetano Heredia, Lima, Perú. Servicio de Gastroenterología, Hospital Cayetano Heredia, Lima, Perú. https://orcid.org/0000-0002-7710-0662

DOI:

https://doi.org/10.17843/rpmesp.2025.424.14674

Keywords:

Esophagitis, Herpes Simplex Virus, Human Immunodeficiency Virus

Abstract

We present the case of a 28-year-old male with diarrhea, headache, and significant weight loss. He was diagnosed with HIV in the AIDS stage (CD4: 3 cells/μL), Cryptococcus neoformans meningoencephalitis, and multisystemic tuberculosis. Given the persistence of diarrhea and negative coproparasitological studies, endoscopic studies were performed. Upper digestive endoscopy incidentally showed esophageal erosions coated with fibrin and punched-out ulcers; these findings were identified as herpetic esophagitis by histopathological and immunohistochemical analysis. Treatment with intravenous acyclovir was initiated, followed by oral administration for 14 days. This case highlights the importance of considering herpetic esophagitis in immunosuppressed patients, even in the absence of esophageal symptoms, and emphasizes
the value of upper digestive endoscopy with biopsy in the comprehensive diagnosis of HIV/AIDS.

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