A case of deep, wide drug-induced esophageal ulcer / 대한내과학회지

ABSTRACT

There are many possible causes of esophageal ulcer, including reflux esophagitis, the ingestion of foreign bodies or caustic agents, radiation exposure, viral infections, tuberculosis, Candida infection, Bechet's disease, and esophageal cancer. Patients with drug-induced esophagitis typically have a history of ingesting medication with little or no fluid immediately before going to bed. Here, we present the case of a 31-year-old man complaining of dysphagia and odynophagia for 4 days. The patient reported taking oral medication for acute sinusitis 12 days prior. Endoscopic examination revealed a large, deep esophageal ulcer consistent with esophageal cancer or cytomegalovirus esophagitis. The exam also revealed several esophageal erosions resembling herpes simplex virus esophagitis. However, based on the patient's history and subsequent histologic findings, drug-induced esophagitis was diagnosed and the patient was successfully treated with a proton pump inhibitor. Lesions showed improvement upon follow-up endoscopy 1 month later.