Herpes Simplex Virus–Induced Tracheoesophageal Fistula in Immunocompetent Adult

Abstract

A 46-year-old man presented in respiratory distress with dysphagia and odynophagia for 1 week. His temperature was 99.1 ℉; heart rate, 105 beats/min; respiratory rate, 18 breaths/min; and oxygen saturation, 74% on ambient air. Laboratory studies revealed leukocytosis, and the chest radiograph was concerning for pneumonia (Figure 1A). Bronchoscopy revealed an approximately 2-cm-diameter tracheoesophageal fistula (TEF) at the main carina tracking to the right main stem bronchus, with the nasogastric tube visualized through the fistula (Figure 1B).