Herpetic esophagitis

Although herpetic esophagitis is generally believed to be rare, a microscopic study of 55 cases of esophagitis encountered in a review of autopsies revealed 14 cases (approximately 25 per cent). The pathology of herpes esophagitis is described and reasons it has been overlooked are discussed. Possible predisposing factors include immunosuppressive therapy and trauma from nasogastric intubation. Herpetic esophagitis was clinically significant in only one patient, but four patients also had herpes pneumonia, a life threatening infection that occurs concomitantly with esophageal involvement. This association should be kept in mind when herpetic esophageal ulcers are observed at autopsy.