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

François-Dufresne, A.; Garbino, Jorge; Ricou, Bara; Wunderli, Werner

doi:10.1007/s001340050339

Cited by 25 publications

(16 citation statements)

References 9 publications

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“…To date, HSV bronchopneumonitis has mostly been described in patients taking immunosuppressants [20,21], with ARDS [22], after surgery [23][24][25][26], or burn victims [27,28]. It was recently demonstrated that HSV bronchopneumonitis was frequently detected among nonimmunocompromised patients with prolonged mechanical ventilation; in our monocentric study, we found that out of 201 patients suspected of having ventilatorassociated pneumonia (VAP), 42 (21%) were diagnosed with HSV bronchopneumonitis.…”

Section: Herpesviridaementioning

confidence: 83%

Viral infections in the ICU

Luyt

Combes

Nieszkowska

et al. 2008

Current Opinion in Critical Care

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Respiratory viruses are responsible for 10% of community-acquired pneumonia cases but do not cause nosocomial pneumonia. Herpesviridae, mainly herpes simplex virus and cytomegalovirus, are commonly detected in the respiratory tract of nonimmunocompromised, mechanically ventilated patients. Although their detection usually reflects viral reactivation without lung parenchymal involvement, in a particular subset of patients, viral lung disease (bronchopneumonitis) occurs. This bronchopneumonitis seems to have a true impact on outcome, but only interventional studies will be able to determine its real impact. Whether other viruses, such as mimivirus, are responsible for nosocomial pneumonia in mechanically ventilated patients requires additional studies.

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Section: Herpesviridaementioning

confidence: 83%

Viral infections in the ICU

Luyt

Combes

Nieszkowska

et al. 2008

Current Opinion in Critical Care

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“…[2] Invasive HSV infections have also been reported in patients taking azathioprine [5–7,13] and methotrexate [14] for IBD. Post-marketing surveillance studies of IBD patients receiving newer immunomodulatory therapies (e.g., biologic therapies) less frequently evaluate the specific risk of HSV infections, as compared to herpes zoster, mycobacterial, and fungal infections.…”

Section: Discussionmentioning

confidence: 99%

Concomitant herpes simplex virus colitis and hepatitis in a man with ulcerative colitis

et al. 2016

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Background:Herpesvirus infections often complicate the clinical course of patients with inflammatory bowel disease; however, invasive disease due to herpes simplex virus is distinctly uncommon.Methods:We present a case of herpes simplex virus colitis and hepatitis, review all the previously published cases of herpes simplex virus colitis, and discuss common clinical features and outcomes. We also discuss the epidemiology, clinical manifestations, diagnosis, and management of herpes simplex virus infections, focusing specifically on patients with inflammatory bowel disease.Results:A 43-year-old man with ulcerative colitis, previously controlled with an oral 5-aminosalicylic agent, developed symptoms of a colitis flare that did not respond to treatment with systemic corticosteroid therapy. One week later he developed orolabial ulcers and progressive hepatic dysfunction, with markedly elevated transaminases and coagulopathy. He underwent emergent total colectomy when imaging suggested bowel micro-perforation. Pathology from both the colon and liver was consistent with herpes simplex virus infection, and a viral culture of his orolabial lesions and a serum polymerase chain reaction assay also identified herpes simplex virus. He was treated with systemic antiviral therapy and made a complete recovery.Conclusions:Disseminated herpes simplex virus infection with concomitant involvement of the colon and liver has been reported only 3 times in the published literature, and to our knowledge this is the first such case in a patient with inflammatory bowel disease. The risk of invasive herpes simplex virus infections increases with some, but not all immunomodulatory therapies. Optimal management of herpes simplex virus in patients with inflammatory bowel disease includes targeted prophylactic therapy for patients with evidence of latent infection, and timely initiation of antiviral therapy for those patients suspected to have invasive disease.

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“…Therefore, the exact role of HSV in ICU patients, ie, as a marker of disease severity or true pathogen with its own morbidity/mortality, remains unclear. 2,5 To date, HSV BPN has mostly been described in patients taking immunosuppressants, 7,8 with acute respiratory distress syndrome (ARDS), 9 after surgery 10 -13 or in burn victims. 14,15 It has been recently demonstrated that HSV bronchopneumonitis was frequently detected among nonimmunocompromised patients with prolonged mechanical ventilation: in a single center study, Luyt et al found that out of 201 patients suspected of having ventilator-associated pneumonia, 42 (21%) were diagnosed with HSV bronchopneumonitis.…”

Section: Signification Of Viral Reactivationmentioning

confidence: 99%

Herpes Simplex Virus Bronchopneumonitis in Patients Receiving Mechanical Ventilation in the Intensive Care Unit

Luyt¹,

Nieszkowska²,

Trouillet³

et al. 2008

Clinical Pulmonary Medicine

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Detection of herpes simplex virus (HSV) in the upper and lower respiratory tracts has been well described. In the throat, the viral reactivation is probably because of the immunoparalysis observed in such patients and/or as a result of microtrauma. However, it is not known whether the isolation of HSV from lower respiratory tract samples of nonimmunocompromised ventilated patients corresponds to bronchial contamination from mouth and/or throat, local tracheobronchial excretion of HSV, or true HSV lung involvement (bronchopneumonitis) with its own morbidity and mortality.The frequency of HSV bronchopneumonitis is variable in the literature but seems to be a common manifestation. Its diagnosis remains difficult because of unspecific clinical, biologic, and radiologic symptoms. HSV bronchopneumonitis is defined as a clinical deterioration, associated with HSV in the lower respiratory tract and HSV-specific nuclear inclusions in the cells of the bronchioloalveolar compartment. Risk factors associated with HSV bronchopneumonitis are immunosuppression, multiorgan failure, surgery, oral-labial lesions, HSV in the throat and macroscopic bronchial lesions seen during bronchoscopy. HSV bronchopneumonitis seems to be associated with longer duration of mechanical ventilation and intensive care unit (ICU) stay, but the efficacy of a specific antiviral agent in this population remains to be determined.

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

Cited by 25 publications

References 9 publications

Viral infections in the ICU

Viral infections in the ICU

Concomitant herpes simplex virus colitis and hepatitis in a man with ulcerative colitis

Herpes Simplex Virus Bronchopneumonitis in Patients Receiving Mechanical Ventilation in the Intensive Care Unit

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