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Case Reports
. 2019 Aug 15;12(8):e230410.
doi: 10.1136/bcr-2019-230410.

Simultaneous candida albicans and herpes simplex virus type 2 esophagitis in a renal transplant recipient

Imran Gani  1 , Vatsalya Kosuru  2 , Muhammad Saleem  2 , Rajan Kapoor  1
Affiliations
Case Reports

Simultaneous candida albicans and herpes simplex virus type 2 esophagitis in a renal transplant recipient

Imran Gani et al. BMJ Case Rep. .

Abstract

Renal transplant recipients are prone to opportunistic infections due to iatrogenic immunosuppression. Infectious esophagitis can present as an opportunistic infection in the post-transplant period. Common pathogens are candida, herpes simplex virus (HSV) and cytomegalovirus (CMV). Having a dual infection is uncommon and the diagnoses can be missed at initial presentation. Our patient, a 29-year-old African-American woman, status post deceased-donor-kidney transplant presented with difficulty and pain in swallowing with clinical features suggestive of candida esophagitis, confirmed by fungal culture. She did not get better with antifungal treatment. On further testing, the patient was found to have HSV-2 infection of the oesophagus as well. She received both fluconazole as well as acyclovir that lead to complete resolution of her symptoms. In the right clinical setting, esophagitis can be caused by more than one organism present at the same time and a high level of suspicion is warranted.

Keywords: endoscopy; hepatitis and other gi infections; infection (gastroenterology); infections; renal transplantation.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
White plaques on tongue and tonsils with bilateral lingual and palatine tonsillar swelling.
Figure 2
Figure 2
Whitish exudate and plaques at the base of the tongue.
Figure 3
Figure 3
Patch of whitish exudates in the oesophagus with underlying esophagitis.
Figure 4
Figure 4
Esophagogastroduodenoscopy 3 weeks later showed complete resolution of esophagitis.
See this image and copyright information in PMC

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