Cytomegalovirus/Herpes Simplex Virus Co-infection with Associated Oesophageal Stricture in a Young Immunocompetent Woman: A Case Report and Literature Review

The authors report the first case of oesophageal cytomegalovirus (CMV) and herpes simplex virus (HSV) co-infection in an immunocompetent patient with an associated oesophagal stricture. The authors also review the literature on oesophageal strictures related to CMV and/or HSV oesophagitis. CMV and HSV co-infection is well documented in immunocompromised patients. The oesophagus is one of several organs known to harbour co-infection. To the knowledge of the authors’, its association with an oesophageal stricture is rare and has only been noted in patients with HIV. The authors report a case of an immunocompetent 40-year-old woman with a past history of iron deficiency anaemia and idiopathic hypertension who presented with dysphagia. Investigations revealed a circumferential oesophageal stricture, with biopsies positive for CMV and HSV. This patient was HIV-negative and had no evidence of immunodeficiency. The patient was treated successfully with valganciclovir and multiple endoscopic oesophageal dilatations. This presentation in an immunocompetent patient has not been described in the literature to the authors’ knowledge and represents a valid differential diagnosis to be recognised in clinical practice.