Herpes simplex esophagitis after renal transplantation

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Abstract
This paper describes five renal transplant recipients, out of a series of 221 consecutive patients, who developed herpes simplex esophagitis. This opportunistic infection presented as odyno- and/or dyspha-gia. It occurred during or shortly after treatment of acute cellular rejection episodes with high doses of steroids and, in four cases, of anti-lymphocyte globulins. The infection responded to acyclovir in all patients. We conclude from these observations that herpes esophagitis occurs during periods of intensive immunosuppression. Because its en-doscopic manifestations are variable, biopsies and cultures are essential to reach the diagnosis. Prevention may be possible by avoiding transplantation from a seropositive donor to a negative recipient and by prophylactic oral acyclovir.