Herpes simplex Virus – The Most Frequently Isolated Pathogen in the Lungs of Patients with Severe Respiratory Distress

Prellner, ThorbjÖRn; Flamholc, Leo; Haidl, Sven; Lindholm, Karin; Widell, Anders

doi:10.3109/00365549209061333

Cited by 76 publications

(70 citation statements)

References 18 publications

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“…Far less commonly HSV1 is found in the lower respiratory tract, although this lower incidence may in part be due to insufficient awareness of HSVP. Prellner et al showed that HSV1 is a far more common pathogen causing pneumonia than suspected [11].…”

Section: Discussionmentioning

confidence: 99%

“…Key words Herpes simplex virusṔ neumonia´Chest radiographÁ RDS state in patients who had had chemotherapy, organ transplantation, or other major surgery, and also in patients infected with human immunodeficiency virus (HIV) or other diseases which decrease immunity [7,8,9,10,11,12]. All these conditions were shown to be associated with an increased risk of herpes simplex virus pneumonia (HSVP).…”

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confidence: 99%

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Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

Umans

Duraku

et al. 2001

Eur Radiol

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The aim of this study was to describe the findings on plain chest radiographs in patients with herpes simplex virus pneumonia (HSVP). The study was based on 17 patients who at a retrospective search have been found to have a monoinfection with herpes simplex virus. The diagnosis was established by isolation of the virus from material obtained during fiberoptic bronchoscopy (FOB) which also included broncho-alveolar lavage and tissue sampling. Fourteen patients had a chest radiograph performed within 24 h of the date of the FOB. Two radiographs showed no abnormalities of the lung parenchyma. The radiographs of the other 12 patients showed lung opacification, predominantly lobar or more extensive and always bilateral. Most patients presented with a mixed airspace and interstitial pattern of opacities, but 11 of 14 showed at least an airspace consolidation. Lobar, segmental, or subsegmental atelectasis was present in 7 patients, and unilateral or bilateral pleural effusion in 8 patients, but only in 1 patient was it a large amount. In contradiction to the literature which reports a high correlation between HSVP and acute respiratory distress syndrome (ARDS), 11 of 14 patients did not meet the pathophysiological criteria for ARDS. The radiologist may suggest the diagnosis of HSVP when bilateral airspace consolidation or mixed opacities appear in a susceptible group of patients who are not thought to have ARDS or pulmonary edema. The definite diagnosis of HSV pneumonia can be established only on the basis of culture of material obtained by broncho-alveolar lavage.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

Umans

Duraku

et al. 2001

Eur Radiol

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“…However, severe disease can develop in immunosuppressed patients: herpetic tracheobronchitis and pneumonia have been described in patients severely immunosuppressed due to burns, malignancies, chemotherapy, transplantation, AIDS, and cell-mediated immunity deficiencies [1,2]. Furthermore, HSV1 has been found (12 %) in the lungs of patients presenting with severe respiratory distress [3][4][5].In this report, we describe a patient with Crohn's disease who developed the acute respiratory distress syndrome (ARDS) due to pneumonia caused by HSV1. …”

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confidence: 99%

ARDS caused by herpes simplex virus pneumonia in a patient with Crohn's disease: a case report

François-Dufresne

Garbino

Ricou³

et al. 1997

Intensive Care Med

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Pneumonia caused by herpes simplex virus type 1 (HSV1) is rare and occurs in severely immunosuppressed patients. HSV1 can be detected in bronchoalveolar lavage (BAL) from patients presenting with respiratory failure, but its direct effect on disease is difficult to prove. We demonstrate the causative role of HSV1 in the case of a 44-year-old male with Crohn's disease who presented to the intensive care unit with the acute respiratory distress syndrome after surgery. BAL cells were cultured and immunofluorescence confirmed the presence of HSV1 during the first weeks of illness. Increased IgG titers confirmed the diagnosis of a recurrent HSV1 infection. A lung biposy specimen showed fibroproliferation without pathogens. Immunosuppressive therapy had been stopped and acyclovir was introduced at this time. The diagnostic difficulties in this patient underline the importance of early recognition of viral infection as a potential cause of severe pneumonia in severely ill, immunocompromised patients.

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“…HSV-1 has previously been found in BAL fluid from immunocompromised patients (40% were AIDS patients) and in BAL fluid from patients with complicated respiratory tract infections [21,22]. The role of HSV-1 recovery in BAL fluid is still unclear, as it is not possible to distinguish between active disease and asymptomatic shedding of the virus.…”

Section: Discussionmentioning

confidence: 99%

Herpesvirus type 1–8 in BAL fluid from HIV-1-infected patients with suspected pneumonia and from healthy individuals

Tarp

Jensen-Fangel²,

Obel³

2001

Eur Respir J

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Pneumonia is still a major problem in human immunodeficiency virus (HIV)-infected patients, and despite extensive investigation the aetiology remains unknown in many cases. The prevalence of the eight human herpesviruses was determined by polymerase chain reaction in 91 samples of bronchoalveolar lavage (BAL) fluid from 72 HIV-infected patients with 91 episodes of suspected pneumonia. The presence of herpesviruses was related to clinical and immunological findings and the prevalence of herpesviruses in HIV-infected patients was compared with the prevalence in BAL fluid from 50 healthy, immunocompetent individuals.Epstein-Barr virus, cytomegalovirus and human herpesvirus-8 (HHV8) were found in 5.5%, 36%, and 5.5% of BAL fluid samples from HIV-infected patients. No herpesviruses were detectable in BAL fluid from healthy, immunocompetent individuals. The herpesviruses occurred mainly in patients with CD4z counts v200610 6 L -1 . All patients with herpesviruses recovered without specific antiviral treatment. Two patients with HHV8 had the diagnosis of Kaposi9s sarcoma.It is concluded that cytomegalovirus, Epstein-Barr virus, and human herpesvirus-8 are frequently present in bronchoalveolar lavage fluid from severely immunocompromised human immunodeficiency virus-infected patients with pulmonary symptoms. In bronchoalveolar lavage fluid from healthy, immunocompetent individuals, herpesviruses are absent. Apart from human herpesvirus-8, the present results indicate that the herpesviruses do not play a serious pathogenic role in the development of pulmonary symptoms in human immunodeficiency virus-infected patients.

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Herpes simplex Virus – The Most Frequently Isolated Pathogen in the Lungs of Patients with Severe Respiratory Distress

Cited by 76 publications

References 18 publications

Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

ARDS caused by herpes simplex virus pneumonia in a patient with Crohn's disease: a case report

Herpesvirus type 1–8 in BAL fluid from HIV-1-infected patients with suspected pneumonia and from healthy individuals

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