Recurrent intra-mural esophageal abscess as a complication of untreated eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a condition characterized by abnormal infiltration of the esophageal mucosa with eosinophils, leading to symptoms such as dysphagia. Common complications, often seen in undertreated cases, include fibrosis-related issues such as food impaction and strictures [1]. We present the case of a patient born in 1999 who, in spring 2021, was admitted with septic dysphagia, leading to the diagnosis of an intramural esophageal abscess. Endoscopy revealed a mucosal tear located 25 cm from the superior dental arch (SDA), while histology confirmed esophageal eosinophilic infiltration exceeding 20 eosinophils per high-power field (HPF). The abscess was resolved with antibiotic therapy, and the patient was prescribed proton pump inhibitors (PPIs). However, due to poor treatment compliance, subsequent gastroscopies revealed a stricture, which required dilation in September 2021.