Herpes esophagitis.

Herpes simplex virus is a well recognized cause of opportunistic esophageal infection, yet there have been few descriptions of the radiographic features of this entity. This report describes the radiographic and clinical findings in six patients with herpes esophagitis. Each patient had clinical evidence of immunosuppression. Acute odynophagia was the most common presenting complaint. Double-contrast esophagrams revealed discrete, widely separated ulcers, plaquelike defects without ulceration, or a combination of ulcers and plaques. Plaquelike lesions in the esophagus can be associated with herpes or moniliasis. However, discrete ulcers on an otherwise normal background mucosa are strongly suggestive of herpes esophagitis. Increased awareness of the radiographic findings should lead to better diagnosis of this entity, so that potentially toxic antifungal drugs can be avoided in patients with herpes esophagitis.