Acute Severe Enteritis by HSV-1 Variant in a Young Patient Who is Immunocompetent

We present a unique case of a 26-year-old man who is immunocompetent with severe abdominal pain and diarrhea, diagnosed with acute severe enteritis caused by a herpes simplex virus type 1 (HSV-1) variant, with intestinal inflammatory changes observed through computed tomography imaging, necessitating an empirical antibiotic. Biopsies from the esophagus and terminal ileum confirmed the presence of HSV-1, with immunostaining highlighting viral inclusion bodies. Notably, the genomic characterization of the HSV-1 variant was elucidated through next-generation sequencing analysis of mucosal biopsy samples from the gastrointestinal tract. The findings contribute to understanding atypical presentations of HSV-1 infection in patients who are immunocompetent and the role of advanced molecular techniques in HSV tropism.