Acute Herpitic Esophagitis
A 64 year old elderly male presented with complaints of vomiting of 4 episodes.He was afebrile, had no oral lesions.
Past medical history revealed that he was hypertensive and is currently on oral treatment for the same since 15 years.
circulation-peripheral pulses present
BP 160/100 mmHg
pulse 82 BPM
RR 12 CPM
Systemic examination -normal
investigations-blood investigations revealed total count 9070cells/cumm, neutrophils 86%
serum electrolytes, urine analysis, RFT, LFT were within normal limits.
He was negative for HIV and HBsAg.
USG of abdomen revealed fatty hepatomegaly
Chest X-ray was normal.
Esophagogastroduodenoscopy-performed on day 4 demonstrated multiple serpiginous ulcerations in the mid and distal esophagus with a normal gastroesophageal junction. Biopsy specimens were positive for HSV.
Diagnosis Acute Herpitic Esophagitis
Management- patient was treated symptomatically with antiemetics, prokinetics and liquid antacids. The patient was started on IV acyclovir and his symptoms began to improve over next 24 to 48 hours.
The patient was advanced to a soft diet and IV acyclovir was continued for 1 week and oral acyclovir for one more week.
The patient had total resolution of his symptoms.