scholarly journals Herpes Simplex Virus Esophagitis in the Setting of Acute Use of Corticosteroids for COPD Exacerbation in an Immunocompetent Middle-Aged Woman

2021 ◽  
pp. 616-620
Author(s):  
Maryam Bilal Haider ◽  
Brinda Basida ◽  
Anusha Bapatla ◽  
Rana Ismail ◽  
Wasif Hafeez
Keyword(s):  
Herpes Simplex ◽  
Complete Resolution ◽  
Case Reports ◽  
Erosive Esophagitis ◽  
Ulcer Formation ◽  
Aged Woman ◽  
Short Course ◽  
Peg Tube ◽  
Simplex Virus ◽  
Esophageal Ulcers

Herpes simplex (HSV) esophagitis is usually identified in patients with significant immunosuppressive conditions such as AIDS. Short course of immunosuppressive therapy is an uncommon risk factor for this condition. We present a case of acute gastrointestinal bleeding secondary to HSV type 1-induced esophageal ulcers. A 63-year-old woman developed acute hypoxic hypercapnic respiratory failure. Past medical history was significant for COPD for which the patient was taking short-acting bronchodilator inhalers. The patient was intubated and started on mechanical ventilation. Intravenous Solu-Medrol 40 mg Q6 was started. Hospital course was complicated by sepsis of unknown source. Empiric broad-spectrum antibiotic therapy was started. On the 11th hospital day, the patient experienced multiple episodes of coffee ground emesis. There was abdominal tenderness on physical examination. Significant laboratory results were lipase 1,911 U/L and lymphopenia (ALC = 300/mm<sup>3</sup>). Endoscopy revealed severe erosive esophagitis and multiple punched-out ulcerations of the esophagus. Empiric treatment with valacyclovir 500 mg OD was started. The patient required PEG tube insertion for dysphagia. Complete resolution of esophagitis was noted then. Immunohistochemical staining for HSV was strongly positive in the cells with inclusions. Short course of intravenous corticosteroids is an uncommon cause of HSV-1 esophagitis. Corticosteroid-induced lymphopenia impedes underlying cellular immunity, which might explain the reactivation of latent herpes and esophageal ulcer formation. Given the rarity of the disease, evidence of treatment is available from case reports only. We found complete resolution of esophageal ulcers after the patient received valacyclovir therapy for 10 days.

scholarly journals A Rare Case of Herpes Simplex Virus-2 Hepatitis with Negative Serology

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mohanad Soliman ◽  
Olalekan Akanbi ◽  
Ihab Almagdub ◽  
Kishore Karri ◽  
Pradeep Yarra ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
High Risk ◽  
Liver Failure ◽  
Complete Resolution ◽  
Rare Case ◽  
High Risk Population ◽  
Pregnant Teenager ◽  
Simplex Virus ◽  
Herpes Simplex Virus 2

Herpes simplex virus-2 (HSV2) hepatitis represents a rare but serious complication of HSV2 infection that can progress to acute liver failure (ALF). We describe a case of a pregnant teenager who presented with four days of fever, headache, malaise, nausea, and vomiting. She was initially misdiagnosed with sepsis of unclear source and treated with broad-spectrum antibiotics. Empiric acyclovir was started one week into her hospitalization despite negative serologies while awaiting HSV2 PCR leading to complete resolution of symptoms. Given its high mortality and nonspecific presentation, clinicians should consider HSV hepatitis in all patients with acute hepatitis especially in high-risk population.

scholarly journals Multi-organ involvement secondary to varicella zoster virus, herpes simplex virus and cytomegalovirus in an immunocompromised patient

2019 ◽  
Vol 12 (3) ◽  
pp. e228150 ◽  
Author(s):  
Ripal Jariwala ◽  
Kristen Zeitler ◽  
Nicole D Riddle ◽  
Chakrapol Sriaroon
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Varicella Zoster Virus ◽  
Immunocompromised Patient ◽  
Case Reports ◽  
Skin Lesions ◽  
Viral Reactivation ◽  
Organ Involvement ◽  
Varicella Zoster ◽  
Simplex Virus

The use of immunosuppressing agents can act as a catalyst for viral reactivation, promoting systemic infection with organ involvement. Current literature remains sparse on this topic but does provide individual case reports involving single viruses. We present the case of an immunocompromised patient with skin lesions, pancreatitis, colitis and hepatitis. Work-up revealed varicella zoster virus, which likely put the patient at risk for multi-organ involvement, as well as clinical suspicion of other implicated viruses, specifically herpes simplex virus and cytomegalovirus. A high clinical index of suspicion along with biopsy guidance for viral involvement in immunocompromised patients is crucial for early diagnosis and treatment of these conditions.

scholarly journals Herpes in the Heart: A Case of Widely Disseminated Intrauterine Herpes Simplex Virus Infection Involving Neonatal Myocardium in a 23-Week Gestationally Aged Neonate

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Hirsch K. Srivastava ◽  
Lindsey T. Ellis ◽  
Douglas C. Miller ◽  
Deiter J. Duff
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Case Reports ◽  
Cutaneous Manifestations ◽  
Ulcer Disease ◽  
Skin Contact ◽  
First Case ◽  
Extremely Preterm ◽  
Simplex Virus ◽  
Herpes Simplex Virus 2

We report a rare case of disseminated herpes simplex virus (HSV) infection in an extremely preterm neonate. Herpes Simplex Virus-2 (HSV-2) is the leading cause of genital ulcer disease in adults and is the most common cause of neonatal herpes, a rare infection associated with long-term neurologic impairment and high mortality. HSV-2 can be transmitted perinatally via direct mucosal or skin contact. Most neonates are infected intrapartum. However, intrauterine transmission does occur, though rarely. The pattern of dissemination described in our patient differs from previous case reports. Most reports indicate that intrauterine HSV infections have a typical triad of cutaneous manifestations, ophthalmologic findings, and neurologic involvement. However, we report the first case of intrauterine disseminated HSV infection in the heart.

Wolf Isotopic Response Manifesting as Postherpetic Granuloma Annulare: A Case Series

2013 ◽  
Vol 137 (2) ◽  
pp. 255-258 ◽  
Author(s):  
Roger Kapoor ◽  
Adriano Piris ◽  
Arturo P. Saavedra ◽  
Lyn M. Duncan ◽  
Rosalynn M. Nazarian
Keyword(s):  
Herpes Zoster ◽  
Herpes Simplex ◽  
Viral Infection ◽  
Case Reports ◽  
Case Series ◽  
Giant Cells ◽  
Granuloma Annulare ◽  
Multinucleated Giant Cells ◽  
Previous Infection ◽  
Simplex Virus

Context.— Wolf isotopic response has infrequently been reported in the literature, mainly as isolated case reports. Objective.— To aid in recognition of the occurrence of postherpetic granuloma annulare for accurate histologic interpretation of granulomatous dermatitides. Design.— We report 5 cases of patients with Wolf isotopic response manifesting as granuloma annulare, developing in a site of previous herpes zoster, and discuss the clinicopathologic findings. Results.— Previous infection with herpes zoster or herpes simplex virus was found in 5 of 5 cases reported. The differential diagnosis of a dermal lymphohistiocytic infiltrate with multinucleated giant cells includes postherpetic granuloma annulare. Conclusions.— All cases of postherpetic Wolf isotopic response reported in this series revealed granuloma annulare, with a perineurovascular or perifollicular pattern of lymphohistiocytic infiltration including multinucleated giant cells, and occurred following herpes zoster or herpes simplex infection, although herpes viral infection was not always associated with a subsequent isotopic eruption. Awareness of this entity can aid in the clinicopathologic diagnosis of granuloma annulare occurring at the site of prior herpes viral infection.

scholarly journals Safety of Alternative Antiviral Agents for Neonatal Herpes Simplex Virus Encephalitis and Disseminated Infection

2014 ◽  
Vol 19 (2) ◽  
pp. 72-82 ◽  
Author(s):  
Yu Wang ◽  
Katherine P. Smith
Keyword(s):  
Herpes Simplex ◽  
Case Reports ◽  
Antiviral Agents ◽  
Clinical Manifestations ◽  
Liver Function Tests ◽  
Reaction Rates ◽  
Herpes Simplex Virus Encephalitis ◽  
Creatinine Concentration ◽  
Neonatal Herpes Simplex ◽  
Simplex Virus

OBJECTIVE: To review the evidence describing the safety of ganciclovir and foscarnet in neonates in order to guide treatment for central nervous system or disseminated herpes simplex infections in cases of acyclovir shortage or resistance. METHODS: PubMed, Ovid Medline, and International Pharmaceutical Abstracts were searched using the thesaurus and text-word terms “ganciclovir” and “foscarnet,” with birth to 1 month age limits. Thirty-two eligible publications describing safety in neonates were identified. RESULTS: In 340 neonates treated for cytomegalovirus (CMV), life-threatening neutropenia (absolute neutrophil count &lt;0.5 × 109/L) was reported in 8.8% of patients following up to 12 months of ganciclovir administered intravenously. Neutropenia and thrombocytopenia occurred in 25.6% and 6.2% of neonates, respectively. Changes in serum creatinine concentration of &gt;0.2 mg/dL occurred in &lt;1% of neonates. Hepatic transaminase increases or unspecified changes in liver function tests were reported in 6.2% of neonates with hyperbilirubinemia being observed in 3.5% of total neonates. Three out of four neonates receiving foscarnet for acyclovir-resistant herpes infection or CMV survived with minimal sequelae. Neither nephrotoxicity nor electrolyte or mineral imbalances were reported. CONCLUSIONS: Similar to what is seen in adolescents and adults, ganciclovir use in neonates is commonly associated with neutropenia, and the frequency of occurrence is comparable. The link between hepatotoxicity and ganciclovir should be interpreted with caution because of overlapping clinical manifestations of CMV. Only case reports are available describing foscarnet use in neonates, but adverse drug reactions were not observed. More research on these two agents is needed to draw conclusions about adverse drug reaction rates in the neonatal population.

scholarly journals AYURVEDIC MANAGEMENT OF ORAL HERPES W.S.R. TO PITHAJA MUKHA-PAKA - A SINGLE CASE REPORT

2021 ◽  
Vol 09 (3) ◽  
pp. 674-676
Author(s):  
Premcy C. R ◽  
Ahalya S ◽  
Pasha S M
Keyword(s):  
Case Report ◽  
Herpes Simplex ◽  
Single Case ◽  
Ulcer Formation ◽  
Single Case Report ◽  
Oral Herpes ◽  
Treat Ment ◽  
The Face ◽  
The Subject ◽  
Simplex Virus

Introduction: Herpes simplex is a viral infection caused by the herpes simplex virus. Oral herpes caus-es the group of blisters called cold sores or fever blisters over the face or mouth. These are having se-vere burning sensation which causes the dysphagia and difficulty in speaking. It is associated with fe-ver. There will be ulcer formation by the rupture of blisters. Oral herpes can be correlated to Pithaja mukhapaka. This is a case report of 41 years old male who complained of severe burning ulcers on hard palate since 1 month. Materials and Methods: The subject who approached Shalakya Tantra OPD of GAMC, with symptoms of burning ulcers over the palate was thoroughly examined and treat-ment was planned based on Chikitsa sutra of Pithaja mukhapaka. Result: The subject had shown good improvement both subjectively and objectively. Discussion: Pithaja mukhapaka is a Sarvasara Mukha-roga with Daha, Oshayuktha Vrana. There for the treatment is focused on pacifying Pitha.

scholarly journals Herpetic Esophagitis in Immunocompetent Medical Student

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Andréia Vidica Marinho ◽  
Vinícius Mendes Bonfim ◽  
Luciana Rodrigues de Alencar ◽  
Sebastião Alves Pinto ◽  
João Alves de Araújo Filho
Keyword(s):  
Human Immunodeficiency Virus ◽  
Medical Student ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Case Reports ◽  
Health Sciences ◽  
Disease Course ◽  
Retrosternal Pain ◽  
Immunodeficiency Virus ◽  
Simplex Virus

Esophagitis caused by herpes simplex virus (HSV) is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV); it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient.

scholarly journals 2652. Cytomegalovirus Meningoencephalitis: A Comparison to Other Viral CNS Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S928-S928
Author(s):  
Stephanie Pankow ◽  
Nigo Masayuki ◽  
Rodrigo Hasbun
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Varicella Zoster Virus ◽  
Clinical Outcomes ◽  
Case Reports ◽  
Immune Deficiency Syndrome ◽  
Varicella Zoster ◽  
Cns Infections ◽  
Immunosuppressed Patients ◽  
Simplex Virus

Abstract Background Cytomegalovirus (CMV) is a rare cause of meningoencephalitis (ME) with clinical data limited to case reports. Methods Retrospective observational study of all viral central nervous system (CNS) infections identified in 17 hospitals in the Greater Houston area from 2000 to 2017. CMV, herpes simplex virus (HSV), varicella zoster virus (VZV), and enterovirus were all identified by a positive cerebrospinal fluid (CSF) polymerase chain reaction (PCR) and all arboviruses were identified by serology. Results A total of 361 patients with viral CNS infections were identified: CMV (n = 33), enterovirus (n = 147), herpes simplex virus (n = 83), varicella zoster virus (n = 28), and arbovirus (n = 70). CMV ME occurred more frequently in immunosuppressed patients [e.g., Acquired Immune Deficiency Syndrome (AIDS)], had more hypoglycorrhachia (59%), and had worse clinical outcomes (61%) as compared with those with HSV, enterovirus, VZV and arboviruses. Furthermore, CMV ME had more altered mental status than enterovirus and HSV and had lower CSF pleocytosis compared with HSV. Additionally, CMV ME had higher CSF protein levels than enteroviral infections and had less CSF lymphocytosis than HSV and VZV. Conclusion CMV meningoencephalitis is seen more frequently in immunosuppressed patients (e.g., AIDS), is associated with more hypoglycorrhachia and have worse clinical outcomes compared with other viral CNS pathogens. Disclosures All authors: No reported disclosures.

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