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Case Reports
. 2024 Dec 27;12(1):e01578.
doi: 10.14309/crj.0000000000001578. eCollection 2025 Jan.

Severe Diffuse Ulcerative Esophagitis Caused by Epstein-Barr Virus/Cytomegalovirus Coinfection in an Immunocompetent Individual

Kartikeya Mathur  1 , Chhagan Lal Birda  1 , Satyam Kumar Singh  1 , Vvienodd Uppuv  1 , Shubham Kashyap  1 , Ashish Agarwal  1
Affiliations
Case Reports

Severe Diffuse Ulcerative Esophagitis Caused by Epstein-Barr Virus/Cytomegalovirus Coinfection in an Immunocompetent Individual

Kartikeya Mathur et al. ACG Case Rep J. .

Abstract

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are important causes of viral esophagitis mainly in immunocompromised individuals. Both viruses lead to development of focal ulcerations in the esophagus. While there have been rare case reports of esophagitis in immunocompetent individuals, there has not been a single reported case of coinfection with both CMV and EBV in an immunocompetent individual and presenting with diffuse esophageal ulceration. We report a case of severe diffuse ulcerative esophagitis caused by EBV/CMV coinfection in an immunocompetent individual.

Keywords: Epstein-Barr virus; cytomegalovirus; esophagitis; infection; viral esophagitis.

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Figures

Figure 1.
Figure 1.
(A) Initial endoscopic examination reveals diffuse ulceration of the esophagus. (B) Endoscopy after 1 month shows near-complete healing of the esophageal ulcerations.
Figure 2.
Figure 2.
Esophageal biopsy suggestive of dense granulation tissue with neutrophils, eosinophils (green arrow), lymphocytes (red arrow), and histiocytes (blue arrow). Eosinophilic CMV inclusion (black arrow) with surrounding halo is noted in an endothelial cell (hematoxylin and eosin, 400×). Overall findings suggestive of active CMV infection. CMV, Cytomegalovirus.
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