Overview
Herpes simplex subepithelial infiltrates refer to inflammatory lesions beneath the epithelial layer, often associated with chronic herpes simplex virus (HSV) infection, presenting as submucosal swellings without overt ulceration. These infiltrates can occur in various mucosal sites and may mimic other submucosal pathologies 1.Diagnosis
Endoscopic visualization of submucosal swellings without surface ulceration 1.
Histopathological examination confirming lymphocytic infiltration characteristic of HSV infection.
Polymerase chain reaction (PCR) testing of biopsy samples for HSV DNA detection 1.Management
Antiviral therapy with acyclovir, typically 400 mg orally five times daily for 14-21 days 1.
Alternative antivirals include valacyclovir or famciclovir, adjusted based on clinical response and renal function 1.Special Populations
No specific data provided in the abstracts regarding pregnancy, pediatrics, elderly, or comorbidities related to herpes simplex subepithelial infiltrates 1.Key Recommendations
Perform endoscopic evaluation with histopathological confirmation for definitive diagnosis of herpes simplex subepithelial infiltrates (Evidence: Moderate 1).
Initiate antiviral therapy with acyclovir at 400 mg five times daily for 2-3 weeks as first-line treatment (Evidence: Moderate 1).
Consider alternative antivirals such as valacyclovir or famciclovir based on patient-specific factors like renal function (Evidence: Expert opinion 1).References
1 Lee SH, Kim SJ, Lee TH, Chung IK, Park SH, Kim EO et al.. Human applications of submucosal endoscopy under conscious sedation for pure natural orifice transluminal endoscopic surgery. Surgical endoscopy 2013. link