Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

Abstract

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.

Herpes simplex virus type-1 pneumonitis in immunocompetent young woman

“…In contrast, HSV pneumonia, either type 1 or 2, is a rare occurrence and almost exclusively observed in immunocompromised hosts (eg, the elderly; bone marrow transplant recipients; and those with malnutrition, malignancy, burns, severe pulmonary disease, or human immunodeficiency virus infection). [1][2][3][4][5][6][7][8][9][10][11][12] HSV is a widespread pathogen isolated from nearly all visceral and mucocutaneous sites, recognized mostly in immunocompromised patients. HSV pneumonia is rare and usually manifests as an acute respiratory distress syndrome.…”

“…Viral culture is useful but may not distinguish a carrier from true infection in 1% to 5% of asymptomatic adults, whereas serology must reveal a 4-fold increase in titer from acute sera; otherwise, an antibody increase may be interpreted as equivocal, especially in recurrent infections. [1][2][3][4][5][6][7][8][9][10][11][12] In regard to transmission, HSV-1 is acquired through contact with oral secretions, gingivostomatitis in children, or recurrent labialis in older hosts. The organism is also involved in approximately 10% to 30% in herpes genitalis.…”

Hallazgos radiológicos de la neumonía por virus herpes simple I en el adulto

“…Se han descrito al respecto tres tipos de evolución clínico radiológica: a) rápidamente regresiva; b) regresión lenta de semanas o meses; y c) progresión hasta la muerte en el 20-50% de síndrome distrés respiratorio agudo (4,9,10).…”

“…Si es neumonitis vírica, la patogénesis es por infección activa de las células epiteliales alveolares, y su presentación, secundaria a la viremia, es durante los tres primeros días de la aparición de la erupción, con un cuadro cínico-radiológico de neumonía por germen atípico. Por el contrario las neumonitis bacterianas son más tardías y tienden a formar focos de condensación y abscesos pulmonares (9,10).…”

Herpes simplex virus pneumonia during standard induction chemotherapy for acute leukemia: case report and review of literature

“…A similar incidence of CD33 expression has been previously reported in MM. 4,5 In CD33-positive patients, the median ratio of fluorescence intensity (RFI) was 14 (range ¼ 6. . When compared to CD33-positive AML, the median MM RFI was equivalent…”