Case Reports| Volume 333, ISSUE 3, P191-193, March 2007

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Combined Herpes Viral and Candidal Esophagitis in a CAPD Patient: Case Report and Review of Literature


      Concomitant herpetic and candidal esophagitis is a very rare disease that had not been reported in uremic patients. A 57-year-old woman receiving continuous ambulatory peritoneal dialysis (CAPD) therapy for 3 years was admitted due to CAPD-related peritonitis. Endoscopic examination was performed due to severe epigastralgia and upper gastrointestinal bleeding, and combined herpetic and candidal esophagitis was diagnosed. Intravenous acyclovir and fluconazole were prescribed and symptoms improved. The patient subsequently died due to progressive sepsis and respiratory failure. This is the first report of a dual infectious esophagitis in a uremic patient. Since infectious esophagitis may cause severe complications, early diagnosis and aggressive treatment are important.


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        • Agha F.P.
        • Lee H.H.
        • Nostrant T.T.
        Herpetic esophagitis: a diagnostic challenge in immunocompromised patients.
        Am J Gastroenterol. 1986; 81: 246-253
        • McDonald G.B.
        • Sharma P.
        • Hackman R.C.
        • et al.
        Esophageal infections in immunosuppressed patients after marrow transplantation.
        Gastroenterology. 1985; 88: 1111-1117
        • Wilcox C.M.
        • Schwartz D.A.
        • Clark W.S.
        Esophageal ulceration in human immunodeficiency virus infection: causes, response to therapy, and long-term outcome.
        Ann Intern Med. 1995; 123: 143-149
        • Ando M.
        • Shibuya A.
        • Yasuda M.
        • et al.
        Impairment of innate cellular response to in vitro stimuli in patients on continuous ambulatory peritoneal dialysis.
        Nephrol Dial Transplant. 2005; 20: 2497-2503
        • Brayko C.M.
        • Kozarek R.A.
        • Sanowski R.A.
        • et al.
        Type I herpes simplex esophagitis with concomitant esophageal moniliasis.
        J Clin Gastroenterol. 1982; 4: 351-355
        • Bonacini M.
        • Young T.
        • Laine L.
        The causes of esophageal symptoms in human immunodeficiency virus infection: a prospective study of 110 patients.
        Arch Intern Med. 1991; 151: 1567-1572
        • Bonacini M.
        • Young T.
        • Laine L.
        Histopathology of human immunodeficiency virus-associated esophageal disease.
        Am J Gastroenterol. 1993; 88: 549-551
        • Fried R.L.
        • Brandt L.J.
        • Kauvar D.
        • et al.
        Esophageal motility in AIDS patients with symptomatic opportunistic infections of the esophagus.
        Am J Gastroenterol. 1994; 89: 2003-2005
        • Mirra S.S.
        • Bryan J.A.
        • Butz W.C.
        • et al.
        Concomitant herpes-monilial esophagitis: case report with ultrastructural study.
        Hum Pathol. 1982; 13: 760-763
        • Rahhal R.M.
        • Ramkumar D.P.
        • Pashankar D.S.
        Simultaneous herpetic and candidal esophagitis in an immunocompetent teenager.
        J Pediatr Gastroenterol Nutr. 2005; 40: 371-373
        • Kurahara K.
        • Aoyagi K.
        • Nakamura S.
        • et al.
        Treatment of herpes simplex esophagitis in an immunocompetent patient with intravenous acyclovir: a case report and review of the literature.
        Am J Gastroenterol. 1998; 93: 2239-2240
        • Baehr P.H.
        • McDonald G.B.
        Esophageal infections: risk factors, presentation, diagnosis, and treatment.
        Gastroenterology. 1994; 106: 509-532
        • Pappas P.G.
        • Rex J.H.
        • Sobel J.D.
        • et al.
        Guidelines for the treatment of candidiasis.
        Clin Infect Dis. 2004; 38: 161-189
        • Hussein M.M.
        • Mooij J.M.
        • Roujouleh H.
        Tuberculosis and chronic renal disease.
        Semin Dial. 2003; 16: 38-44