RESUMEN
We herein report a case of a 79-year-old Japanese woman who developed severe oral stomatitis during methotrexate (MTX) treatment for dermatomyositis. She had been treated with MTX (12 mg/week) and prednisolone (5 mg/day) for dermatomyositis for 4 years. She developed painful stomatitis, fever, and pancytopenia. Initially, her symptoms were suspected to be caused by mucosal toxicity of MTX. Therefore, the drug was discontinued, and leucovorin was administered. However, oral stomatitis worsened in a few days, resulting in intolerance of oral ingestion due to severe pain. Polymerase chain reaction revealed the presence of herpes simplex virus type 1 (HSV-1) in oral erosive lesions, and blood examination was positive and negative for anti-HSV IgG and anti-HSV IgM, respectively. Therefore, HSV-1 reactivation-induced oral stomatitis was diagnosed, and acyclovir treatment was started, which promptly improved oral stomatitis. HSV-1 reactivation is usually asymptomatic or results in localized vesicular lesions at the mucocutaneous junction of the lips in immunocompetent individuals. Our case illustrates that HSV-1 reactivation induces severe stomatitis in patients treated with low-dose MTX for autoimmune diseases, not just in those with severe immunosuppressive conditions. Of note, HSV-1 reactivation-induced stomatitis is a diagnostic challenge, especially during MTX treatment.
Asunto(s)
Dermatomiositis/tratamiento farmacológico , Herpesvirus Humano 1/fisiología , Metotrexato/efectos adversos , Reinfección/virología , Estomatitis Herpética/virología , Activación Viral , Anciano , Anticuerpos Antivirales/sangre , Biomarcadores/sangre , Femenino , Herpesvirus Humano 1/inmunología , Humanos , Huésped Inmunocomprometido , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Metotrexato/administración & dosificación , Reacción en Cadena de la Polimerasa , Prednisolona/administración & dosificación , Prednisolona/efectos adversos , Reinfección/diagnóstico , Índice de Severidad de la Enfermedad , Estomatitis Herpética/diagnósticoRESUMEN
BACKGROUND: Primary herpetic gingivostomatitis (PHGS) in children, though usually self-limited, might mimic bacterial and enteroviral pharyngitis clinically. We conducted a study to define the clinical features of PHGS in children. METHODS: Between January 2012 and December 2016, 282 inpatients aged less than 19 years with cell culture-confirmed herpes simplex virus (HSV) infection in a medical center were identified from the virologic laboratory logbook. Clinical data were retrospectively collected. RESULTS: Among the 282 inpatients, 185 cases were considered as PHGS and were included for analysis. Fever was present in 99.5%. The mean duration of fever was 5.11 days (±2.24) with the longest being 17 days. Common oral manifestations included oral ulcers (84.3%), which equally resided in the anterior and posterior part of the oral cavity (65.4% vs. 63.2%), gum swelling and/or bleeding (67.6%), and exudate coated tonsils (16.8%). Leukocytosis (WBC count > 15,000/uL3) was noted in 52 patients (28.1%) and a serum C-reactive protein level > 40 mg/L in 55 patients (29.7%). Fixty-five patients (35%) were diagnosed with PHGS on admission and were significantly more likely to have ulcers over the anterior oral cavity (76.1% vs. 26.7%) and gum swelling/bleeding (76.2% vs. 7.5%, p-value all < 0.001) on admission and were significantly less likely to receive antibiotic treatment (16.9 vs. 36.7%, p-value < 0.01) than others. Forty-six patients (25%) undiagnosed as PHGS on discharge were significantly more likely to have exudate coated on the tonsils, to receive antibiotic treatment and significantly less likely to have gum swelling/bleeding and oral ulcers (all p-values < 0.01). CONCLUSIONS: Meticulously identifying specific oral manifestations of gum swelling/bleeding and ulcers over the anterior oral cavity in children can help making the diagnosis of PHGS earlier and subsequently reduce unnecessary prescription of antibiotics.
Asunto(s)
Gingivitis/diagnóstico , Herpes Simple/diagnóstico , Herpesvirus Humano 1/inmunología , Úlceras Bucales/diagnóstico , Faringitis/diagnóstico , Estomatitis Herpética/diagnóstico , Tonsilitis/diagnóstico , Adolescente , Antibacterianos/uso terapéutico , Proteína C-Reactiva/análisis , Niño , Preescolar , Diagnóstico Diferencial , Diagnóstico Precoz , Femenino , Fiebre , Herpes Simple/tratamiento farmacológico , Herpes Simple/virología , Herpesvirus Humano 1/aislamiento & purificación , Humanos , Lactante , Leucocitosis , Masculino , Estudios Retrospectivos , Estomatitis Herpética/tratamiento farmacológico , Estomatitis Herpética/virologíaRESUMEN
In our case, we want to highlight the importance of screening for opportunistic infectious diseases in these immunosuppressed patients. We present the case of an erythema nodosum triggered by reactivation of Herpes Simplex Virus (HSV) in a patient with ulcerative colitis.
Asunto(s)
Colitis Ulcerosa/inmunología , Eritema Nudoso/inmunología , Huésped Inmunocomprometido/efectos de los fármacos , Estomatitis Herpética/inmunología , Tobillo/virología , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/virología , Eritema Nudoso/virología , Femenino , Humanos , Ilustración Médica , Paladar Blando/virología , Estomatitis Herpética/virología , Adulto JovenAsunto(s)
Fiebre Chikungunya/inmunología , Inmunidad Innata , Infecciones por Papillomavirus/inmunología , Estomatitis Herpética/inmunología , Fiebre Chikungunya/virología , Virus Chikungunya/inmunología , Herpesvirus Humano 1/inmunología , Humanos , Papillomaviridae/inmunología , Infecciones por Papillomavirus/virología , Literatura de Revisión como Asunto , Estomatitis Herpética/virologíaRESUMEN
Herpes simplex virus type 1 (HSV-1) infection activates a rapid stimulation of host innate immune responses and a delicate interplay between virus and host immune elements regulates the whole events. Although host immune elements play well in limiting the HSV-1 infection by interfering viral replication, they are still unable to remove the virus completely, because HSV-1 proteins are efficient enough to bypass the host antiviral immune responses and virus succeed to reactivate again from latency at opportune time. Type 1 interferon signaling pathway is the central point of innate immunity along with some of the activated neutrophils, monocytes, macrophages, and dendritic cells, and some natural killer cells play role, while the CD8+ T cells are crucial in adaptive immunity. In this review, the current knowledge of host and HSV-1 interaction has been described that how the host antiviral immune responses occur and what are the mechanisms of viral evasion adapted by virus to counteract with both arms of immunity.
Asunto(s)
Herpesvirus Humano 1/inmunología , Interacciones Huésped-Patógeno/inmunología , Evasión Inmune , Inmunidad Innata , Estomatitis Herpética/inmunología , Linfocitos T CD8-positivos/inmunología , Linfocitos T CD8-positivos/metabolismo , Humanos , Interferón Tipo I/inmunología , Interferón Tipo I/metabolismo , Transducción de Señal/inmunología , Estomatitis Herpética/virología , Activación Viral/inmunología , Latencia del Virus/inmunología , Replicación Viral/inmunologíaRESUMEN
Herpes Simplex Virus (HSV) hepatitis in liver transplant patients is a rarely reported infective complication of HSV with severe consequences, often leading to fulminant hepatitis if left untreated. The clinical signs are often atypical, leading to under-reporting in the literature and potential delays in treatment. Our case report describes such atypical mucocutaneous lesions in a liver transplant recipient. We highlight the need for further reports, especially those with images, in order to aid the diagnosis of HSV infection, and to allow prompt treatment to prevent complications such as HSV hepatitis.
Asunto(s)
Hepatitis Viral Humana/virología , Herpes Simple/virología , Herpesvirus Humano 1 , Trasplante de Hígado/efectos adversos , Complicaciones Posoperatorias/virología , Estomatitis Herpética/virología , Adulto , Femenino , Humanos , Boca/virologíaRESUMEN
Herpes simplex virus type 1 (HSV-1) had led to kinds of clinical disorders and became an important cause of morbidity and mortality worldwide, such as herpetic gingivostomatitis in children. Previous studies reported that HSV-1 infection is common and has evolved a variety of mechanisms to evade the immune system, such as dysregulation of miRNAs. However, reports concerning the role of miRNA in HSV-1infection are limited. Here, we report that a host microRNA, miR-373, was significantly upregulated by HSV-1 infection in Hela cells and patients with herpetic gingivostomatitis and it facilitated HSV-1 replication in vitro. Subsequently, we demonstrated that miR-373 was a negative regulator of IFN-I response by directly targeting IRF1, resulting in the suppression of interferon stimulated gene (ISG) expression and enhancement of HSV-1 infection. Taken together, our findings provide new evidence of which HSV-1 hijacks the host miRNAs to promote its replication by negatively regulating the production of type I IFN and suggest a novel potential anti-HSV-1 therapeutic target.
Asunto(s)
Herpesvirus Humano 1/fisiología , Factor 1 Regulador del Interferón/genética , MicroARNs/genética , Replicación Viral/genética , Animales , Estudios de Casos y Controles , Células HeLa , Humanos , Interferón Tipo I/metabolismo , Ratones , Ratas , Estomatitis Herpética/genética , Estomatitis Herpética/virología , Regulación hacia ArribaAsunto(s)
Carcinoma de Células Escamosas/cirugía , Colgajos Tisulares Libres , Neoplasias de la Boca/cirugía , Estomatitis Herpética/diagnóstico , Estomatitis Herpética/virología , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/virología , Anciano , Diagnóstico Diferencial , Glosectomía , Humanos , Masculino , Escápula/trasplanteAsunto(s)
Aciclovir/efectos adversos , Antivirales/efectos adversos , Hemodiafiltración/métodos , Fallo Renal Crónico/terapia , Síndromes de Neurotoxicidad/terapia , Diálisis Renal , Estomatitis Herpética/tratamiento farmacológico , Aciclovir/administración & dosificación , Aciclovir/sangre , Anciano , Antivirales/administración & dosificación , Antivirales/sangre , Femenino , Humanos , Fallo Renal Crónico/diagnóstico , Fallo Renal Crónico/fisiopatología , Síndromes de Neurotoxicidad/diagnóstico , Síndromes de Neurotoxicidad/fisiopatología , Síndromes de Neurotoxicidad/psicología , Recuperación de la Función , Estomatitis Herpética/diagnóstico , Estomatitis Herpética/virología , Resultado del TratamientoRESUMEN
Feline odontoclastic resorptive lesion (FORL) and feline chronic gingivostomatitis (FCGS) are two of the most common diseases of the feline oral cavity. While evidence is emerging that FCGS is caused by gingival inflammation initiated and perpetuated by the oral microbiota, little is known in this regard for FORL. Feline calicivirus (FCV) has been associated with the presence of FCGS and is thought to play a role in the initiation of this disease. In this study, the incidence of FCV was investigated in cats with FORL and FCGS, and compared to unaffected controls. FCV was detected by viral culture. The incidence of FCV was as follows: 6 (24.0%) of 24 control cats, 9 (22.5%) of 40 cats with FORL and 15 (60.0%) of 25 cats with FCGS were positive for FCV. There was a significant difference in FCV incidence between all the groups (p=0.003) but none between the control group and the FORL group. However, significant differences were observed in the incidence of FCV between control and FCGS (p=0.010) and between FORL and FCGS (p=0.006). It is concluded that although FCV may be associated with FCGS, it appears unlikely to play a role in FORL.
Asunto(s)
Infecciones por Caliciviridae/veterinaria , Calicivirus Felino/aislamiento & purificación , Enfermedades de los Gatos/epidemiología , Resorción Radicular/veterinaria , Estomatitis Herpética/veterinaria , Animales , Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/virología , Estudios de Casos y Controles , Enfermedades de los Gatos/virología , Gatos , Femenino , Incidencia , Masculino , Missouri/epidemiología , Prevalencia , Resorción Radicular/epidemiología , Resorción Radicular/virología , Estomatitis Herpética/epidemiología , Estomatitis Herpética/virologíaRESUMEN
This review on herpes simplex virus type I and type II (HSVI, HSVII) summarizes recent developments in clinical manifestations and treatment interventions for primary and recurrent orolabial and genital herpes, as well as those regarding vaccination issues. Among the clinical presentations, the relationship between pyogenic granuloma and chronic HSVI infection; HSV-related folliculitis; verrucous HSVI and HSVII lesions; the role of recurrent HSVI infection in burning mouth syndrome; HSVI and HSVII infection of the periareolar area; zosteriform HSV; the "knife-cut sign"; and the preferential colonization and infection of preexisting dermatoses by HSVI or HSVII are discussed. The usual antiviral treatment regimens for primary and recurrent orolabial and genital herpes are compared to short-term and one-day treatment options. New anti-HSVI and anti-HSVII agents include amenavir, pritelivir, brincidofovir, valomaciclovir, and FV-100. Therapeutic or preventive vaccination against HSVI and HSVII infections still remains a highly desirable treatment aim, which, unfortunately, has no clinically relevant applications to date.
Asunto(s)
Herpes Simple/virología , Herpesvirus Humano 1/patogenicidad , Herpesvirus Humano 2/patogenicidad , Aciclovir/uso terapéutico , Antivirales/uso terapéutico , Síndrome de Boca Ardiente/diagnóstico , Síndrome de Boca Ardiente/tratamiento farmacológico , Síndrome de Boca Ardiente/virología , Herpes Genital/diagnóstico , Herpes Genital/tratamiento farmacológico , Herpes Genital/virología , Herpes Labial/diagnóstico , Herpes Labial/tratamiento farmacológico , Herpes Labial/virología , Herpes Simple/diagnóstico , Herpes Simple/tratamiento farmacológico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia , Estomatitis Herpética/diagnóstico , Estomatitis Herpética/tratamiento farmacológico , Estomatitis Herpética/virología , Vacunación , Virulencia , Zoster Sine Herpete/diagnóstico , Zoster Sine Herpete/tratamiento farmacológico , Zoster Sine Herpete/virologíaRESUMEN
Herpes zoster in the prodromal stage may be mistaken for other diseases characterized by pain in the area of prodrome, such as dental pain. We report on a case of trigeminal herpes zoster, which presented as sudden onset headache and acute temporomandibular pain in the prodromal phase.
Asunto(s)
Cefalea/diagnóstico , Herpes Zóster/diagnóstico , Síndrome de la Disfunción de Articulación Temporomandibular/diagnóstico , Enfermedades del Nervio Trigémino/virología , Adulto , Diagnóstico Diferencial , Dermatosis Facial/virología , Humanos , Masculino , Trastornos Migrañosos/diagnóstico , Úlceras Bucales/virología , Estomatitis Herpética/virologíaAsunto(s)
Convalecencia , Enterocolitis Seudomembranosa/complicaciones , Trastornos Psicofisiológicos/complicaciones , Conducta Autodestructiva/diagnóstico , Sepsis/etiología , Cuidados de la Piel/efectos adversos , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/psicología , Anciano , Antibacterianos/uso terapéutico , Antifúngicos/uso terapéutico , Antiparasitarios/uso terapéutico , Clostridioides difficile/aislamiento & purificación , Cara , Femenino , Humanos , Conducta Autodestructiva/complicaciones , Conducta Autodestructiva/psicología , Sepsis/tratamiento farmacológico , Simplexvirus/aislamiento & purificación , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/patología , Estomatitis Herpética/diagnóstico , Estomatitis Herpética/virología , Inconsciencia/etiologíaAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Herpes Simple/inducido químicamente , Infecciones Oportunistas/inducido químicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Simplexvirus/efectos de los fármacos , Activación Viral/efectos de los fármacos , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Asparaginasa/efectos adversos , Asparaginasa/uso terapéutico , Infecciones Bacterianas/inducido químicamente , Preescolar , Ciclofosfamida/efectos adversos , Ciclofosfamida/uso terapéutico , Citarabina/efectos adversos , Citarabina/uso terapéutico , Daunorrubicina/efectos adversos , Daunorrubicina/uso terapéutico , Encefalitis por Herpes Simple/inducido químicamente , Encefalitis por Herpes Simple/diagnóstico , Resultado Fatal , Femenino , Trasplante de Células Madre Hematopoyéticas , Herpes Simple/virología , Humanos , Quimioterapia de Inducción , Lactante , Masculino , Mercaptopurina/efectos adversos , Mercaptopurina/uso terapéutico , Metotrexato/efectos adversos , Metotrexato/uso terapéutico , Infecciones Oportunistas/virología , Prednisona/efectos adversos , Prednisona/uso terapéutico , Estomatitis Herpética/inducido químicamente , Estomatitis Herpética/virología , Vincristina/efectos adversos , Vincristina/uso terapéuticoRESUMEN
Herpes simplex virus type 1 is one of the most frequent causes of oral infection in humans, especially during early childhood. Several experimental models have been developed to study the pathogenesis of this virus but all of them employed adult animals. In this work, we developed an experimental model that uses mice younger than 4 days old, to more closely resemble human infection. Mice were infected subcutaneously with the prototype strain McIntyre of Herpes simplex-1, and the progression of infection was studied by immunoperoxidase. All animals died within 24-72 h post-infection, while viral antigens were found in the oral epithelium, nerves and brain. The most striking result was the finding of viral antigens in the nucleus and cytoplasm of cells belonging to striated muscles. Organotypic cultures of striated muscles were performed, and viral replication was observed in them by immunocytochemistry, electron microscopy and viral isolation. We conclude that the infection of striated muscles is present from the onset of oral infection and, eventually, could explain some clinical observations in humans.
Asunto(s)
Herpesvirus Humano 1/fisiología , Músculo Estriado/virología , Estomatitis Herpética/virología , Lengua/virología , Animales , Animales Recién Nacidos , Antígenos Virales/análisis , Encéfalo/virología , Causas de Muerte , Núcleo Celular/virología , Chlorocebus aethiops , Citoplasma/virología , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Ratones , Ratones Endogámicos BALB C , Mucosa Bucal/virología , Células Musculares/virología , Músculo Estriado/inervación , Fibras Nerviosas/virología , Neuronas/virología , Organismos Libres de Patógenos Específicos , Estomatitis Herpética/inmunología , Técnicas de Cultivo de Tejidos , Lengua/inervación , Células Vero , Replicación Viral/fisiologíaAsunto(s)
Infecciones por Citomegalovirus/virología , Citomegalovirus/patogenicidad , Dermatitis Exfoliativa/etiología , Enfermedad Injerto contra Huésped/etiología , Simplexvirus/patogenicidad , Estomatitis Herpética/virología , Timoma/complicaciones , Neoplasias del Timo/complicaciones , Activación Viral , Antivirales/uso terapéutico , Biopsia , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/tratamiento farmacológico , Dermatitis Exfoliativa/diagnóstico , Dermatitis Exfoliativa/terapia , Femenino , Glucocorticoides/uso terapéutico , Enfermedad Injerto contra Huésped/diagnóstico , Enfermedad Injerto contra Huésped/terapia , Humanos , Persona de Mediana Edad , Recurrencia , Estomatitis Herpética/diagnóstico , Estomatitis Herpética/tratamiento farmacológico , Timoma/secundario , Neoplasias del Timo/patología , Resultado del Tratamiento , Terapia UltravioletaRESUMEN
BACKGROUND: Infections caused by acyclovir-resistant isolates of herpes simplex virus (HSV) after hematopoietic stem cell transplantation (HSCT) are an emerging concern. An understanding of the evolutionary aspects of HSV infection is crucial to the design of effective therapeutic and control strategies. METHODS: Eight sequential HSV-1 isolates were recovered from an HSCT patient who suffered from recurrent herpetic gingivostomatitis and was treated alternatively with acyclovir, ganciclovir, and foscavir. The diverse spectra and temporal changes of HSV drug resistance were determined phenotypically (drug-resistance profiling) and genotypically (sequencing of the viral thymidine kinase and DNA polymerase genes). RESULTS: Analysis of 60 clones recovered from the different isolates demonstrated that most of these isolates were heterogeneous mixtures of variants, indicating the simultaneous infection with different drug-resistant viruses. The phenotype/genotype of several clones associated with resistance to acyclovir and/or foscavir were identified. Two novel mutations (E798K and I922T) in the viral DNA polymerase could be linked to drug resistance. CONCLUSIONS: The heterogeneity within the viral populations and the temporal changes of drug-resistant viruses found in this HSCT recipient were remarkable, showing a rapid evolution of HSV-1. Drug-resistance surveillance is highly recommended among immunocompromised patients to manage the clinical syndrome and to avoid the emergence of multidrug-resistant isolates.