Pulmonary herpes simplex in burns patients

Byers, Richard; Ps, Hasleton; Quigley, Alicia; Dennett, C; Klapper, Paul E.; Cleator, Graham M.; Faragher, E. B.

doi:10.1183/09031936.96.09112313

Cited by 66 publications

(42 citation statements)

References 28 publications

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“…HSV tracheobronchitis was first reported in 1949 [1]. Pulmonary involvement of the lower respiratory tract by HSV in adults has been reported in recipients of solid organ and stem cell transplantations [2,3], and in patients with burns [4], terminal cancer [5,6], AIDS [7] or patients receiving corticosteroids [8]. Herpes tracheobronchitis and bronchopneumonia have also been reported in immunocompetent patients, particularly in the elderly [9,10].…”

Section: Discussionmentioning

confidence: 99%

Endobronchial pseudo-tumour caused by herpes simplex

Upadya

Tilluckdharry²,

Nagy³

et al. 2005

Eur Respir J

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Herpes simplex virus (HSV) causes tracheobronchitis and pneumonitis; however, to date, there has only been one report of an endobronchial mass caused by HSV type II.This case study describes a 68-yr-old female with severe kyphoscoliosis who was intubated for acute on chronic hypercapnic respiratory failure and developed blood-tinged endotracheal secretions.Fibreoptic bronchoscopy demonstrated an endobronchial mass in the right middle lobe. Cultures grew HSV type I and biopsy specimens demonstrated cytopathological changes consistent with HSV infection. This is the first reported case of HSV type I presenting as an endobronchial tumour.

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Section: Discussionmentioning

confidence: 99%

Endobronchial pseudo-tumour caused by herpes simplex

Upadya

Tilluckdharry²,

Nagy³

et al. 2005

Eur Respir J

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“…HSV pneumonia should be suspected if patients also show mucocutaneous involvement. A high incidence of pulmonary HSV infection was described in the lungs of burn patients and especially associated with acute respiratory distress syndrome [18]. The diagnosis of HSV pneumonia usually requires tissue confirmation, and coinfection with other pathogens is not rare.…”

Section: Viral Infectionsmentioning

confidence: 99%

The Lung in the Immunocompromised Patient

Tamm

1999

Respiration

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Pulmonary infections decisively contribute to morbidity and mortality in immunocompromised patients. Bacterial, mycobacterial and infections with Pneumocystis carinii have been reviewed in an article in the last issue of Respiration. In this review, viral and fungal pulmonary infections are discussed in HIV-positive patients and in patients treated with high-dose chemotherapy, stem cell or solid-organ transplantation.

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“…Additionally, Byers et al have demonstrated a strong association between HSV and adult respiratory distress syndrome (ARDS) in burn patients (6). In their study, 13 out of 16 ARDS cases were positive for HSV.…”

Section: Case Reportmentioning

confidence: 90%

Thymidine Kinase Sequence Analysis of Herpes Simplex Virus Type 1 Strains Present in Different Compartments in an Atypical Impetiginous Rash on the Lesional Skin of a Burn Patient

et al. 2008

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We report the case of a 23-year-old male burn patient with an unusual herpes simplex virus (HSV) skin manifestation. The clinical symptoms and results of HSV type 1 (HSV-1) UL23 polymorphism analysis from saliva and lesional skin underscores the need for performing molecular analysis of HSV-1 infections in burned patients presenting unusual skin lesions. CASE REPORTAn otherwise healthy, 23-year-old male patient with 32% total body surface area burns was transferred to our burn center. The patient sustained superficial second-degree burns on the face and neck, on both arms, extending from the hand to the upper arms, and on front and back areas of both lower legs and knees. The injury was caused by a workplace-related gas burner explosion.Initially the patient was intubated and a bronchoscopy was performed. There were no signs of an inhalation injury. The wounds were surgically debrided, and a Vaseline gauze dressing was applied. Daily dressing changes were performed.Due to gram-positive bacteria in tracheal secretions, antibiotic treatment with a cephalosporin was administered for 7 days. The patient was extubated on day 7.On postburn day 10, a sudden increase in the patient's temperature to near 39°C was noticed, and a deterioration of his general condition was evident. Pneumonia was excluded by X rays of the chest. At this point we also removed the central line catheter.Twenty-four hours after the onset of fever, the patient developed yellowish seromucus-covered erosions in the burned skin areas. The focal point of the rash was on the arms, the neck, and the underpart of the face ( Fig. 1 and 2). The patient reported merely some light tension on the affected areas but severe pain. Based on the symptoms and the shape of the blisters, we suspected both bacterial and herpes simplex virus type 1 (HSV-1) infection. Swabs of the blister revealed Staphylococcus epidermidis, and molecular analysis for HSV-1, cytomegalovirus (CMV), and varicella-zoster virus (VZV) revealed HSV-1 infection.On admission the patient was immunoglobulin G (IgG) positive for HSV, CMV, and VZV (20 July 2006). No enhanced CMV IgG levels were observed, and no antiherpesvirus IgM was detectable by enzyme-linked immunosorbent assay. A lesional wound swab from skin of the upper arm on postburn day 11 (1 August 2006) revealed the presence of HSV-1 DNA (H724) by a real-time PCR protocol with melting-point analysis for discrimination between HSV-1 and -2 (5). From the same swab, PCR for VZV and CMV DNA was negative. Serology for HSV IgM was negative, and complement fixation revealed an enhanced titer of 160 at 11 days postburn (1 August 2006). On day 12 after the thermal insult (2 August 2006), HSV-1 was isolated from a throat swab (H723) and a throat wash by microculture using monolayers of human foreskin fibroblasts and Vero cells. The HSV-specific cytopathic effects in both cell cultures were confirmed by immunoperoxidase staining of HSV glycoprotein D by an in situ enzyme-linked immunosorbent assay. At the same time, PCR results for CMV from leuko...

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Pulmonary herpes simplex in burns patients

Cited by 66 publications

References 28 publications

Endobronchial pseudo-tumour caused by herpes simplex

Endobronchial pseudo-tumour caused by herpes simplex

The Lung in the Immunocompromised Patient

Thymidine Kinase Sequence Analysis of Herpes Simplex Virus Type 1 Strains Present in Different Compartments in an Atypical Impetiginous Rash on the Lesional Skin of a Burn Patient

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