Mr P. F. Jones comments

In the May issue of the Archives (1977, 52, 414), Valerio and co-workers report congenital oesophageal stenosis in a 7-week-old baby with swallowing difficulties. Oesophagoscopy showed a stenotic area and dilatations were successful. They mention that recurrent regurgitation had occurred during the third and fourth week, and that serological evidence of herpes simplex infection was reported in both mother and child. We believe that the latter might well be the cause of the lesion of the oesophagus. In 1973, we reported 2 cases of neonatal herpes simplex infection proved by culture and serological reactions, resulting after 5 weeks in oesophageal stenosis which was cured by dilatations (Laboureau et al., 1973). In a third observation (unpublished) a newborn had herpes vesicles in several areas of the skin (positive virus culture) and developed severe oesophagitis with a number of small ulcers and purpuric spots over the whole extent of the mucous membrane, seen by fibreoscopy. X-ray showed a 'congenital stenosis', but earlier the barium swallow had shown many small defects of the wall of the oesophagus, interpreted as ulcers. Topical treatment and levamisole were given and no stenosis occurred. The oesophageal localization of neonatal herpes simplex infection seems to be a frequent occurrence (Felder et al., 1960; Langvad and Voigt, 1963; Becker et al., 1968; Miller et al., 1970), but so far most of such lesions have been found at necropsy. We emphasize that they should be routinely looked for by fibreoscopy in any baby having herpes simplex infection, and our findings support the hypothesis that they may not infrequently result in oesophageal stenosis. A. ROSSIER, G. DE MONTIS, and J. P. CHABROLLE Service de Pediatrie B, Hopital Saint Vincent de Paul (Faculte de Medecine Cochin Port Royal), 74 Avenue Denfert Rochereau, 75674 Paris Cedex 14, France.