Herpes simplex virus 2 hepatitis in a lung transplant recipient: a diagnostic challenge

Hirschi, Sandrine; Biondini, Davide; Ohana, Mickaël; Solis, Morgane; D’Urso, Antonio; Rosner, V.; Kessler, Romain

doi:10.1111/tid.12459

Cited by 10 publications

(6 citation statements)

References 19 publications

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“…S olid organ transplant recipients are highly susceptible to infections that sometimes have uncommon clinical manifestations (1)(2)(3). Etiologic diagnosis of hepatitis is even more problematic in organ transplant recipients because a wide range of possible drug toxicities induced by immunosuppressive therapies must be considered (4). Diagnosing unexplained hepatitis remains a challenge, as exemplified by 74 cases of acute hepatitis of unknown etiology reported in children in the United Kingdom, 3 cases in Spain, and up to 5 possible cases in Ireland (5).…”

mentioning

confidence: 99%

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Pérot¹,

Fourgeaud²,

Rouzaud³

et al. 2023

Emerg. Infect. Dis.

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In March 2022, a 61-year-old woman in France who had received a heart-lung transplant sought treatment with chronic hepatitis mainly characterized by increased liver enzymes. After ruling out common etiologies, we used metagenomic next-generation sequencing to analyze a liver biopsy sample and identified an unknown species of circovirus, tentatively named human circovirus 1 (HCirV-1). We found no other viral or bacterial sequences. HCirV-1 shared 70% amino acid identity with the closest known viral sequences. The viral genome was undetectable in blood samples from 2017–2019, then became detectable at low levels in September 2020 and peaked at very high titers (10 10 genome copies/mL) in January 2022. In March 2022, we found >10 8 genome copies/g or mL in the liver and blood, concomitant with hepatic cytolysis. We detected HCirV-1 transcripts in 2% of hepatocytes, demonstrating viral replication and supporting the role of HCirV-1 in liver damage.

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mentioning

confidence: 99%

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Pérot¹,

Fourgeaud²,

Rouzaud³

et al. 2023

Emerg. Infect. Dis.

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“…The clinical course may be more severe and insidious in LT recipients; additionally, the response to the antiviral therapy is slower [20]. Although mucocutaneous involvements are usually asymptomatic, diffuse mucocutaneous lesions may occur and, if progressive, may extend to the esophagus or lung [21]. In our study, we detected the mucocutaneous involvement in 92.3% of the patients, disseminated disease were in 6.1% of the patients, Also, it was observed that majority of the patients who developed more than one viremia episode had acute and/or chronic rejection.…”

Section: Resultsmentioning

confidence: 99%

Karaciğer nakli alıcılarında herpes simpleks virüs viremisinin tanısı, klinik görünümleri ve tedavi yönetimi

Kose

Toplu

Gönültaş

et al. 2021

Turkish Journal of Clinics and Laboratory

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Aim:We aimed to evaluate the clinical variations, possible risk factors and results of diagnostic procedures in liver transplant (LT) recipients who suffered from Herpes Simplex Virus (HSV) viremia in the post-transplant period, despite Cytomegalovirus (CMV) prophylaxis. Material and methods:The data of 1100 LT recipients were evaluated retrospectively. HSV DNA RT-PCR detected in blood and vesicular fluid samples of the patients with active painful mucocutaneous vesicular lesions and patients with organ involvement who had biopsy and confirmed HSV viremia were included in the study. The 110 recipients diagnosed with HSV viremia were included.Results: In 110 recipients, total 130 HSV viremia episodes were observed over sixty months. HSV viremia rate was 11.8%. Of the 130 HSV episodes, 120 (92.3%) were mucocutaneous form of the disease. In 10 cases, there was a specific organ involvement. HSV-1 was detected in all of viremia episodes. Sixty-four (49.2%) episodes developed six months after the LT, 41 (31.5%) episodes developed between the 1st and 6th months after LT, and 25 (20.3%) episodes were observed within the first postoperative month. All episodes were treated successfully with different antiviral therapy modalities. Conclusion:Despite CMV prophylaxis performed, HSV viremia may be occurred as a wide range of clinical presentation in LT recipients. It can be seen at any time point after the LT. HSV DNA RT-PCR from serum samples may not be sufficient for diagnosis of viremia, therefore the analysis of the vesicular fluid or the biopsy from the organs may be necessary for supporting the diagnosis.

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“…In advanced stage, fibroblast proliferation and fibrosis of meningeal collagen are finally fund that can lead to an event of arachnoid and piamater thickening, even to mutual adhesion of them. In the last stage, it can cause a blockage of apertura medialis ventriculi quarti, apertura lateralis ventriculi quarti, ring pool of midbrain that in turn formed hydrocephalus [21]. Polysaccharide antigen examinations of staphylococcus aureus capsular in serum and cerebrospinal fluid are contributed to diagnose the cryptococcosis infection of the nervous system.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Study of Nine HIV-Associated Central Nervous System Complications from Imaging Analysis

Liu¹

2019

Med Case Rep J

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The central nervous system (CNS) is preferentially vulnerable to HIV infection with respect of chronic exposure to HIV in the brain as well as combination infection of HIV and opportunistic pathogens that can lead to cognitive impairment. In order to shed light of characterizations of HIVassociated CNS complications, 9 HIV-associated CNS complications were analyzed by computed tomography (CT) and magnetic resonance imaging (MRI). In the 9 cases, characterizations of HIV-associated encephalitis, HIV-associated encephalitis of toxoplasma infection, cytomegalovirus infection, cryptococcosis infection and herpes simplex infection, HIVassociated white matter complication, HIV-associated cerebral infarction, HIV-associated cerebral encephalitis of syphilis infection, and HIVassociated cerebral glioma were detected by imaging. These HIV-associated CNS complications not only respectively showed few common features of non-HIV-associated CNS complications, but exhibited specific traits. HIVassociated CNS complications showed typical clinical and radiological presentations are sufficient to establish the diagnosis.

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Herpes simplex virus 2 hepatitis in a lung transplant recipient: a diagnostic challenge

Cited by 10 publications

References 19 publications

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Karaciğer nakli alıcılarında herpes simpleks virüs viremisinin tanısı, klinik görünümleri ve tedavi yönetimi

Preliminary Study of Nine HIV-Associated Central Nervous System Complications from Imaging Analysis

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