Work

A Tale of Two Infections: A Rare Synchronous Infection of Herpes Simplex Virus Oesophagitis and Clostridium difficile in an Immunocompetent Host

Year: 2025

Type: article

Abstract: Herpes simplex virus (HSV) is a common cause of infectious oesophagitis, predominantly affecting immunocompromised populations. Clostridium difficile (C. difficile), while prevalent in this population, is also a frequently encountered cause of nosocomial diarrhoea associated with antibiotic exposure, prolonged hospitalisation, or residence in long-term care facilities. A simultaneous HSV oesophagitis and C. difficile infection (CDI), despite the absence of the typical risk factors, is rare but possible, as illustrated by the following case. A 95-year-old female patient presented with acute confusion, abdominal pain, diarrhoea, odynophagia, and dysphagia. The stool sample detected toxigenic C. difficile, and a course of fidaxomicin was completed. Oesophagogastroduodenoscopy (OGD) observed mucosal changes consistent with HSV oesophagitis, but treatment was initially withheld due to pending histopathology. She was readmitted due to the recurrence of her symptoms. HSV was confirmed, and the patient started on dual antimicrobial therapy with marked improvement and resolution. This case study prompts us to consider non-traditional risk factors such as immunosenescence, frailty, proton pump inhibitors (PPIs), and nutritional deficiencies in addition to the lack of primary prevention measures.

Source: Cureus

DOI: 10.7759/cureus.94660

Authors: Sujata Lama, Aye Thinzar Moe, Amirat Akinloye, Kyaw Soe Tun, Jithin Karedath

Institutions: King's College Hospital NHS Foundation Trust, King's College Hospital, Dartford And Gravesham NHS Trust, Southmead Hospital

Language: English

Topic: Clostridium difficile and Clostridium perfringens research

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Ministry of Education, India