Upper Gastrointestinal Hemorrhage from Esophageal Ulcer Caused by Coinfection of Herpes Simplex Virus and Cytomegalovirus in Immunocompromised Patient

ABSTRACT

Coinfection with herpes simplex virus and cytomegalovirus is a very rare cause of esophageal ulcer and upper gastrointestinal hemorrhage. A 26 year-old male kidney transplant recipient was referred with a complaint of melena. Upper gastrointestinal endoscopy showed a huge esophageal ulcer in the anastomosis site of the esophagogastrostomy. The ulcer occupied about two-thirds of the circumference of the esophageal lumen and an exposed vessel in the ulcer base was noted. Pathologic findings with immunohistochemical stain showed co-infection of herpes simplex virus and cytomegalovirus. He was treated successfully with endoscopic hemostasis and antiviral therapy. We report a case of upper gastrointestinal hemorrhage from esophageal ulcer caused by coinfection of herpes simplex virus and cytomegalovirus.