case_images: PMC11810145_01
case_images: CT of the soft tissue of the head and neck with contrast revealing a borderline enlarged left cervical lymph node measuring 2.1x1.2 cm. CT: computed tomography
case_images: cureus-0017-00000077293-i01.jpg
case_images: PMC11810145_01_cureus-0017-00000077293-i01.jpg
case_images: FIG1
case_images: The ED ordered computed tomography (CT) of the head and neck to evaluate for possible etiologies of dysphagia; CT revealed a borderline enlarged left cervical lymph node posterior to the left angle of the mandible measuring 2.1x1.2 cm (Figure 1).
case_images: (A) Multiple discrete shallow ulcers in the middle third of the esophagus. (B) Friable mucosa, erythema, and exudate were present in the lower third of the esophagus
case_images: cureus-0017-00000077293-i02.jpg
case_images: PMC11810145_01_cureus-0017-00000077293-i02.jpg
case_images: FIG2
case_images: The EGD revealed discrete shallow ulcers in the middle third of the esophagus (Figure 2A). Friable mucosa, erythema, and exudate were present in the lower third of the esophagus (Figure 2B).
case_images: (A) Histological features of HSE showing Cowdry A intranuclear inclusion bodies in infected epithelial cells (H&E, x400). (B) Immunohistochemistry technique with positive immunostaining demonstrating intranuclear inclusions (anti-HSV-1 antibody, x200). HSE: herpes simplex esophagitis; H&E: hematoxylin and eosin; HSV: herpes simplex virus
case_images: cureus-0017-00000077293-i03.jpg
case_images: PMC11810145_01_cureus-0017-00000077293-i03.jpg
case_images: FIG3
case_images: Histology showed eosinophilic round intranuclear bodies (Cowdry A inclusion bodies) (Figure 3A) with positive herpes simplex virus (HSV)-1 immunostaining (Figure 3B).