Herpetic tracheitis in association with rituximab therapy

Thong, Lorraine; Plant, Barry J.; McCarthy, John; Murphy, Desmond M.

doi:10.1002/rcr2.158

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…HSV causes tracheitis in adult patients who are immunocompromised, on mechanical ventilation, corticosteroid administration, and who have acquired immunodeficiency syndrome (AIDS) [8,9]. There are limited reports regarding isolated tracheitis caused by HSV.…”

Section: Discussionmentioning

confidence: 99%

Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus

2021

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Clinically significant isolated viral tracheitis is scarce in adults, and upper airway obstruction caused by viral tracheitis is even more infrequent. A 74-year-old woman, who was administered low-dose steroids for two months for chronic obstructive pulmonary disease (COPD), developed dyspnea with stridor and required mechanical ventilation for respiratory failure. Chest computed tomography showed a diffuse tracheal wall thickening with luminal narrowing and peribronchial consolidation in the right upper lobe. Bronchoscopy revealed a proximal tracheal narrowing with multiple ulcerations of the tracheal mucosa surrounded by an erythematous margin. Pathologic examinations of the tracheal mucosal tissue, including immunohistochemistry, revealed a cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Furthermore, the bronchial alveolar lavage fluid was positive on the CMV real-time polymerase chain reaction. The patient was treated with intravenous ganciclovir for 44 days. The follow-up bronchoscopy 49 days after the initiation of ganciclovir revealed improved multiple ulcerations with scars. We report a rare case of tracheitis caused by coinfection with CMV and HSV in a patient with COPD who had been taking low-dose steroids for months. The case showed that CMV and HSV are potential causes of serious tracheitis and respiratory failure.

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Section: Discussionmentioning

confidence: 99%

Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus

2021

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“…Endobronchial findings of central airway disease caused by HSV include fungating and endobronchial masses, polypoid lesions, mucosal irregularities, and ulcerations causing airway stenosis. Necrotic and vesicular blistering lesions have also been identified (60,(126)(127)(128)(129)(130)(131)(132). The clinical significance of herpetic tracheobronchial disease is unknown as these patients tend to be critically ill with a high overall morbidity and mortality.…”

Section: Bronchoscopic Findings In Viral Caoimentioning

confidence: 99%

“…The treatment of choice for nocardial disease is trimethoprim-sulfamethoxazole (TMP-SMX), but minocycline and imipenem have also been successful (142). HSV and VZV tracheitis and endobronchial diseases have been conventionally treated with acyclovir and valacyclovir (60,127,128,130). Endobronchial CMV infection is usually treated with ganciclovir (39,123,124).…”

Section: Medical Managementmentioning

confidence: 99%

Infections causing central airway obstruction: role of bronchoscopy in diagnosis and management

Keshishyan¹,

DeLorenzo²,

Hammoud³

et al. 2017

J. Thorac. Dis.

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Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways. However, bronchoscopy is commonly used to confirm and obtain a specific diagnosis to guide specific therapy. In recent years, interventional pulmonology (IP) is becoming widely available and offer a minimally invasive approach for the management of central airway diseases such as cancers, benign strictures, and other conditions. Various bronchoscopic modalities are used to treat central airway obstruction (CAO), such as mechanical debulking, endobronchial laser therapy, electrocautery, argon plasma coagulation, cryotherapy, and airway stenting. In patients with CAOI, the role of therapeutic bronchoscopy is not clearly defined, but many isolated reports in the literature described bronchoscopic intervention in combination with medical therapy as the initial management approach. In this paper, we present cases of CAOI that underwent bronchoscopic intervention as part of their management. We described the infectious etiology, locations, bronchoscopic findings and bronchoscopic modalities for airway management.

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