Herpes Simplex Esophagitis—A Study in Autopsy Series

Autopsy cases were reviewed in order to determine the incidence and underlying diseases of herpes esophagitis. Review of both autopsy records and the preserved viscera of 145 cases disclosed 9 cases (6%) of herpes esophagitis. Herpes simplex virus type I specific antigen was detected in all of these nine cases by immunohistochemical method. Eight of nine cases had malignant diseases. Review only of autopsy records of other 254 cases disclosed 5 cases (2%) of herpes esophagitis. Thus, herpes esophagitis is thought to be more common than has previously been appreciated and may be overlooked at autopsy. Although antemortem diagnosis of this condition has been very rare, clinicians should have an accurate knowledge of this disease because herpetic esophageal ulcer may act as a portal of entry for generalized dissemination of virus and other pathogens, and effective antiviral agents are becoming available.