Case Report A Patient with Eosinophilic Esophagitis and Herpes Simplex Esophagitis: A Case Report and Literature Review Hemnishil K. Marella , 1 Jiten P. Kothadia, 1 Nasir Saleem, 1 Bilal Ali, 1 Yousef Abdel-Aziz, 1 Vamsee Mupparaju, 2 Twisha Oza, 3 Abdallah Azouz, 3 and Colin W. Howden 1 1 Division of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, TN 38104, USA 2 Methodist University Hospital, Memphis, TN 38104, USA 3 Department of Pathology, University of Tennessee Health Science Center, Memphis, TN 38104, USA Correspondence should be addressed to Hemnishil K. Marella; hkmarella@gmail.com Received 22 February 2021; Revised 7 May 2021; Accepted 19 May 2021; Published 25 May 2021 Academic Editor: Ken Haruma Copyright©2021HemnishilK.Marellaetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Acute herpes simplex esophagitis (HSE) is common in immunocompromised patients. Eosinophilic esophagitis (EoE) is characterized by immune-mediated eosinophil-predominant esophageal inflammation. We report a patient with human im- munodeficiency virus infection who presented with dysphagia and odynophagia and was found to have HSE and EoE. e combination of these two relatively rare conditions suggests possible predisposition. 1. Introduction Eosinophilic esophagitis (EoE) is a chronic immune and antigen-mediated disorder characterized by an eosinophil- predominant inflammation of the esophagus resulting in esophageal dysfunction symptoms [1]. Although once con- sidered rare, its reported incidence is increasing partly due to better recognition and improved understanding of the disease process [2–4]. Its most frequent symptoms in adults are dysphagia and food impaction [1]. e diagnosis of EoE is established on clinical, endoscopic, and histologic grounds after other etiologies of symptoms and esophageal eosino- philia are excluded. Histological diagnosis is based on the presence of at least 15 eosinophils per high-power field (hpf) on esophageal mucosal biopsies [1]. Environmental factors, atopy, genetics, and impaired esophageal epithelial barrier function are possible predisposing factors for EoE [1]. Herpes simplex esophagitis (HSE) is an acute viral in- fection of the esophagus that may cause odynophagia and/or dysphagia, chest pain, and fever [5]. Herpes simplex virus (HSV) lesions are typically found in the mid-to-distal esophagus and can be confirmed histologically by immu- nohistochemistry, viral culture, or polymerase chain reac- tion [6]. e occurrence of concomitant HSE and EoE is rare [7–10]. We report a case of concomitant HSE and EoE in an immunocompromised patient and have described a well- referenced review on the subject. 2. Case Report A 51-year-old African American woman with a past medical history significant for a history of gastroesophageal reflux disease and HIV presented with a one-year history of dysphagia and odynophagia. She was receiving elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide for HIV infection. Her most recent CD4 count was 207 cells/mm 3 , and her viral load was 84,700 copies/mL. She complained of odynophagiaanddysphagiaatthelevelofherneck,aswellas some epigastric discomfort. She reported weight loss of 5 pounds over six months. She denied any history of atopic disorders. She noticed painful lesions at the edge of her tongue. She had been taking omeprazole 40 mg daily for the preceding six months without symptom improvement. Over the preceding 2-3 years, her CD4 count had been ≤200 with high viral loads. Despite previous poor compliance, she had recently been compliant with all her HIV medications. On examination, there were several 2 mm shallow ulcers at the edge of her tongue but no evidence of oral Candida Hindawi Case Reports in Gastrointestinal Medicine Volume 2021, Article ID 5519635, 3 pages https://doi.org/10.1155/2021/5519635