An Unusual Contributor to the Cause of Wound Dehiscence

Diagnosis

Herpes Virus infection, an unexpected contributor to the postsurgical dehiscence of an esophageal incision.

The coexistence of viral and bacterial infection at the site of wound dehiscence is intriguing. It is not possible to say which infection, viral or bacterial, preceded the other. Surgical wound dehiscence due to Herpes Virus has been reported at the site of corneal transplants ². Since herpetic ulcers in the esophagus tend to be superficial, it is possible that the initial event was the Herpes virus infection and then secondary bacterial superinfection from the contents of the esophagus.

Herpes esophagitis that occurs in immunocompetent hosts has been attributed to reactivation of prior viral infection ^{1, 2}. Although Herpes virus esophagitis is often asymptomatic and discovered at at autopsy examination, some patients may present with odynophagia.

Documentation of a major visceral surgical wound dehiscence due to herpes simplex reactivation or infection was not found in the English medical literature. This case may represent the first documented example of a major visceral postsurgical wound dehiscence due to herpetic esophagitis resulting in the demise of the patient.