Infectious esophagitis in immunocompetent individuals: case series in a tertiary care hospital

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Aims The prevalence of infectious esophagitis in immunocompetent individuals is unusual. The main aetiological agent is HSV-1, affecting in most cases individuals under 40 years of age with severe odynophagia and dysphagia as main symptoms. It is not known whether SARS CoV-2 infection or administration of its vaccine are predisposing factors. The aim is to determine the main clinical, diagnostic and endoscopic features and response to treatment of patients diagnosed with viral esophagitis since the beginning of the pandemic. Methods A case series of immunocompetent patients with viral esophagitis in the Complejo Asistencial Universitario de León from March 2020 to January 2022 is included ([ Fig. 1 ]). Fig. 1 Results A total of five patients were diagnosed with viral esophagitis. The personal, clinical, diagnostic and therapeutic data of all cases is listed in Table 1. Conclusions Viral esophagitis in immunocompetent patients is rare, leading to under-diagnosis. It should be suspected in acute cases of intense odynophagia. In our series, histological diagnosis was compatible in only 40% of cases. As this is a self-limiting infection in immunocompetent individuals, there are discrepancies between administering acyclovir or only treating symptoms. SARS CoV-2 infection or the administration of its vaccines could act as predisposing factors, although further studies are needed to establish this relationship. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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