You are here

Article Text

Article menu
Download PDFPDF
Case report
Acute oesophageal necrosis in a patient with recent SARS-CoV-2
  1. Nada F Mustafa1,
  2. Nadim S Jafri2,
  3. Heidi L Holtorf1 and
  4. Shinil K Shah1,3
  1. 1Department of Hospital Medicine, Memorial Hermann Sugar Land Hospital, Sugar Land, Texas, USA
  2. 2Department of Gastroenterology and Hepatology, Memorial Hermann Healthcare System, Houston, Texas, USA
  3. 3Department of Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  1. Correspondence to Dr Nada F Mustafa; nada.mustafa{at}memorialhermann.org

Abstract

A 57-year-old Hispanic man with diabetes presented with dyspnoea. He had a positive SARS-CoV-2 PCR. He was intubated for severe hypoxia and treated with intermittent pressors, methylprednisolone and supportive care. He was extubated on hospital day (HD) 9 and discharged to a skilled nursing facility (SNF) on HD 18. Approximately 1 month later, he presented with melena. Endoscopy revealed two large 1.5–2 cm wide-based distal oesophageal ulcers without active bleeding. Histology showed ulcerated squamous mucosa with extensive necrosis extending to the muscularis propria and coccoid bacterial colonies with rare fungal forms suggestive of Candida. He was treated with fluconazole and pantoprazole and was discharged to a SNF. Approximately 3 weeks later, he was readmitted for complications. Repeat endoscopy demonstrated improvement and histology revealed chronic inflammation with reactive epithelial changes. Incidentally, SARS-CoV-2 PCR was positive during this visit without any respiratory symptoms.

  • oesophagus
  • COVID-19
  • GI bleeding
  • adult intensive care

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-244164

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors NFM: Conception/design, drafting/revision; acquisition/analysis/interpretation of data; final approval; article guarantor. NSJ: Acquisition/analysis/interpretation of data; revision; final approval. HLH: Acquisition/analysis/interpretation of data; revision; final approval. SKS: Design; drafting/revision; acquisition/analysis/interpretation of data; final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.