Results and Conclusion:
Biopsies confirmed a coinfection of CMV and HSV-1. Treatment commenced with valganciclovir and a temporary halt to mycophenolate, resulting in undetectable CMV levels subsequently. A follow-up EGD conducted two months later showed that the esophageal ulcers had no new bleeding, and biopsies indicated candida esophagitis without signs of CMV or HSV infection. The diagnosis of CMV and HSV-1 coinfection is a rare occurrence but crucial to identify due to its association with higher complication rates, including perforation and bleeding (1).