PMC4532066_01
Endoscopy revealed multiple, well-circumscribed vesicular eruptions scattered along the entire esophagus and the lesions varied in size from 0.3cm to 0.5cm in diameter. These vesicular lesions were dark red, not coalescent, and easily removable by biopsy forceps without remnant ulcer.
kjim-9-2-120-12f2.jpg
PMC4532066_01_kjim-9-2-120-12f2.jpg
f1-kjim-9-2-120-12
There were multiple dark red, grouped and discrete vesicles of 3 to 5mm in diameter along the entire esophagus (Fig. 1,2).
Light microscopy revealed multi-nucleated giant cells and Cowdry type A intranuclear inclusions (x400, HE stain).
kjim-9-2-120-12f3.jpg
PMC4532066_01_kjim-9-2-120-12f3.jpg
f3-kjim-9-2-120-12
Light microscopy showed characteristic intranuclear inclusions and multi-nucleated giant cells (Fig. 3).
In situ hybridization for type 1 herpes simplex virus gave positive signals as small dark red dots(x 100).
kjim-9-2-120-12f4.jpg
PMC4532066_01_kjim-9-2-120-12f4.jpg
f4-kjim-9-2-120-12
For the confirmation of herpes esophagitis, in situ hybridization of herpes viral DNA was performed, resulting in a positive test for type 1 herpes simplex (Fig. 4).