RESUMO
BACKGROUND: Pneumonia due to herpes simplex virus (HSV) is uncommon but can be seen in immunocompromised patients and has been associated with poor prognosis in this population. AIM: The aim was to study the results, outcome and mortality of HSV pneumonia in immunocompromised patients and patients receiving mechanical ventilation. Furthermore, it has been unclear whether to initiate prophylactic treatment with acyclovir or not. METHODS: We have conducted a literature search using the keywords herpes simplex pneumonia, critically ill patients and intensive care unit for identification of relevant publications. FINDINGS: HSV pneumonia can cause severe infection or even death in immunocompromised patients and critically ill patients. A clear diagnosis of HSV pneumonia can be difficult to establish. Respiratory condition may improve after initiation of acyclovir but data is scarce. CONCLUSION: HSV pneumonia should be considered in the immunocompromised patient and/or the intensive care patient who continues to deteriorate despite appropriate treatment. The value of prophylactic treatment with acyclovir is unproven but should be considered.
Assuntos
Herpes Simples , Herpesvirus Humano 1 , Pneumonia Viral , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Humanos , Unidades de Terapia Intensiva , Pneumonia Viral/tratamento farmacológicoRESUMO
A 72-year-old woman with diabetes mellitus was admitted to our hospital because of dyspnea on exertion. Sputum cytologic evaluation revealed intranuclear inclusion bodies in the cells; we therefore considered viral pneumonia and performed a bronchoscopy. The bronchial washing fluid was positive for immunoperoxidase staining of herpes simplex virus type 1 (HSV1) and HSV1 polymerase chain reaction. The patient was diagnosed as having pneumonia due to HSV1 and was successfully treated with acyclovir.
Assuntos
Herpes Simples/diagnóstico , Herpesvirus Humano 1 , Pneumonia Viral/diagnóstico , Insuficiência Respiratória/etiologia , Idoso , Broncoscopia , Feminino , Herpes Simples/complicações , Herpes Simples/terapia , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Insuficiência Respiratória/diagnóstico por imagemRESUMO
A sputum test is noninvasive and simple. It contributed to correct diagnosis of a patient with severe acute respiratory failure. We again point out the usefulness of sputum cytodiagnosis for differentiating severe pneumonia.