Cytomegalovirus and Herpes Simplex Virus Co-Infection in an HIV-Negative Patient: A Case Report
| Autor: | Zhiwei Yin, Mirela Feurdean, Sung H Choi, Angelica C Gangemi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Fulminant
cytomegalovirus (cmv) Congenital cytomegalovirus infection Infectious Disease 030204 cardiovascular system & hematology medicine.disease_cause Allergy/Immunology 03 medical and health sciences odynophagia 0302 clinical medicine medicine cell-mediated immunity hsv-2 hsv-1 cytomegalovirus pneumonitis Cytomegalovirus esophagitis immunosenescence Respiratory distress business.industry General Engineering Bacterial pneumonia virus diseases medicine.disease herpes simplex virus Thrombocytopenic purpura oral ulcer Herpes simplex virus Immunology cytomegalovirus esophagitis medicine.symptom business Odynophagia 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Herpes simplex virus (HSV) and cytomegalovirus (CMV) infections are commonly seen in immunocompromised patients, particularly in patients with HIV. However, fulminant CMV infection and concurrent infection with HSV and CMV in non-HIV patients are quite rare. We present the case of a 72-year-old HIV-negative man with a history of oropharyngeal carcinoma in remission and recent treatment of immune thrombocytopenic purpura with high-dose steroids who was transferred from an outside hospital for Ear Nose and Throat (ENT) evaluation of a non-healing buccal ulcer. During initial presentation, the patient was found to be febrile with acute hypoxic respiratory failure and a chest x-ray suggestive of bacterial pneumonia, though he failed to improve with broad-spectrum antibiotic therapy. He underwent esophagogastroduodenoscopy for dysphagia, which revealed a discrete ulcer positive for CMV. Biopsy of his buccal lesion was ultimately positive for HSV-1 and HSV-2. The patient's clinical status improved significantly following the initiation of antiviral therapy.It is important to consider CMV infection in the setting of persistent fever, respiratory distress, or dysphagia in the non-HIV infected patient, especially in the setting of prolonged steroid use. CMV and HSV infection can occur simultaneously at distinct sites in the body, and CMV infection may predispose to HSV reactivation due to its long term effect on cell-mediated immunity. Early recognition of opportunistic infections and initiation of antiviral therapy in immunocompromised patients can greatly affect length of hospital stay, morbidity, and, ultimately, mortality. |
| Databáze: | OpenAIRE |
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