Severe Bleeding from Herpes Esophagitis

We describe a patient with the unusual complication of massive upper gastrointestinal bleeding secondary to herpetic esophagitis, whose bleeding persisted despite a vigorous antireflux regimen but who responded dramatically to intravenous acyclovir. The patient is reported to underscore the importance of considering herpetic infection of the esophagus as a cause of severe gastrointestinal bleeding so that appropriate therapy may be instituted.