Oesophageal herpes simplex virus (HSV) infection

Oesophageal herpes simplex virus (HSV) infection typically presents with dysphagia (difficulty swallowing) and odynophagia (painful swallowing) in severely immunocompromised patients, though it can occur in immunocompetent patients. Diagnosis requires endoscopy with a biopsy for histopathology (including immunostaining) and polymerase chain reaction (PCR).

To treat oesophageal HSV infection in adults, use:

aciclovir 5 mg/kg intravenously, 8-hourly until oral therapy is possible1. For dosage adjustment in adults with kidney impairment, see aciclovir intravenous dosage adjustment oesophagitis, herpes simplex virus aciclovir    

FOLLOWED BY

1 famciclovir 500 mg orally, 12-hourly to complete a 10-day course. For dosage adjustment in adults with kidney impairment, see famciclovir dosage adjustment oesophagitis, herpes simplex virus famciclovir    

OR

1 valaciclovir 1 g orally, 12-hourly to complete a 10-day course. For dosage adjustment in adults with kidney impairment, see valaciclovir dosage adjustment. oesophagitis, herpes simplex virus valaciclovir    

1 Aciclovir dosing in obesity is poorly defined; however, limited data support dosing based on adjusted body weight in adults. For simplicity, some centres recommend a maximum dosing weight of 100 kg (eg 1 g for 10 mg/kg doses, 1.5 g for 15 mg/kg doses).Return