Author/Editor		Vodovnik, A; Cerar, A
Title		Synchronous herpes simplex virus and cytomegalovirus esophagitis
Type		članek
Source		Z Gastroenterol
Vol. and No.		Letnik 38, št. 6
Publication year		2000
Volume		str. 491-4
Language		eng
Abstract		Infective esophagitis is a rare disease, affecting mostly immunocompromised patients. Very few cases of a multiple viral infection have been reported. We present a case of combined cytomegalovirus (CMV) and herpes simplex virus (HSV) esophagitis in an 81-year-old female with extracapillary sclerosing glomerulonephritis treated for five months with steroids and chemotherapy. She died of septic shock. At autopsy, erosive and ulcerative esophagitis was found in the distal half of the esophagus. Slides were stained by HE, and the immunohistochemical avidin-biotin method was used to detect HSV and CMV infection. On histological examination of the esophagus, epithelial giant cells with intranuclear viral inclusions showing HSV immunopositivity were found at the margin of the ulcerations. Giant cells with intranuclear inclusions with CMV immunopositivity were also found in the mesenchymal cells obtained from the ulcer bed. Long-term immunosuppressive therapy provoked an immune deficiency, evidenced by grave leukopenia and depletion of all bone marrow elements. Diagnosis of HSV and CMV esophagitis is important to evaluate the risk of hemorrhage and esophageal perforation in esophagitis.
Descriptors		CYTOMEGALOVIRUS INFECTIONS ESOPHAGITIS HERPES SIMPLEX OPPORTUNISTIC INFECTIONS AGED, 80 AND OVER CYCLOPHOSPHAMIDE DIAGNOSIS, DIFFERENTIAL DRUG THERAPY, COMBINATION ESOPHAGUS GLOMERULOSCLEROSIS, FOCAL IMMUNOENZYME TECHNIQUES IMMUNOSUPPRESSIVE AGENTS INCLUSION BODIES METHYLPREDNISOLONE