ABSTRACT
Herpetic geometric glossitis is a unique morphologic variant of HSV (herpes simplex virus) type 1 infection on the dorsum of the tongue that presents as an extremely painful linear central lingual fissure with a branched pattern. in the center of the tongue; there is a branched pattern of fissures that extend bilaterally from the central linear fissure. Herpetic geometric glossitis has been reported in 11 patients; 8 of these individuals were immunocompromised. Medical conditions and immunosuppressive medication treatment (7 patients) or only medical disorders (3 patients) or neither (1 patient) were present. HSV type 1 infection was diagnosed by viral culture in (7 patients), Tzanck preparation (2 patients) or clinically (2 patients). Mucocutaneous HSV infection at non-lingual locations--including the lips, labial mucosa, face and chest--were observed in 5 patients. All patients' symptoms and lesions responded to treatment with oral antiviral therapy: acyclovir (9 patients), famciclovir (1 patient) or valacyclovir (1 patient). The lingual pain and dorsal tongue fissures completely resolved completely within two to 14 days. In summary, herpetic geometric glossitis is a unique HSV type 1 infection, usually in immunocompromised patients, that occurs on the dorsal tongue and responds completely after treatment with orally administered antiviral therapy.
Subject(s)
Antiviral Agents , Glossitis , Herpes Simplex , Herpesvirus 1, Human , Immunocompromised Host , Humans , Glossitis/drug therapy , Glossitis/virology , Middle Aged , Female , Male , Antiviral Agents/therapeutic use , Herpes Simplex/drug therapy , Herpes Simplex/diagnosis , Herpesvirus 1, Human/isolation & purification , Adult , Aged , Acyclovir/therapeutic use , Valacyclovir/therapeutic use , Valine/analogs & derivatives , Valine/therapeutic use , Famciclovir/therapeutic useABSTRACT
Multiple species of elephant endotheliotropic herpesvirus (EEHV) have caused fatal hemorrhagic disease in African (Loxodonta africana) and Asian (Elephas maximus) elephants. To date, EEHV7 has been detected only in benign pulmonary and skin nodules and in saliva of African elephants and has not been associated with clinical illness. Low-level viremia due to EEHV7A was detected via qPCR in two subadult African elephants during routine surveillance. Hematologic changes were noted in both elephants, including leukopenia, lymphopenia, monocytopenia, and band heterophilia. Treatment was initiated with famciclovir, antimicrobials, and rectal fluids, and one elephant received plasma transfusions due to a progressive decrease in platelet count. Both elephants remained asymptomatic throughout the viremias, with rapid resolution of hematologic abnormalities. These cases add to the current understanding of the epidemiology of EEHV in African elephants; to the authors' knowledge, they represent the first documentation of clinical disease due to EEHV7 infection in any elephant.
Subject(s)
Elephants , Herpesviridae Infections , Herpesviridae , Humans , Animals , Herpesviridae Infections/diagnosis , Herpesviridae Infections/epidemiology , Herpesviridae Infections/veterinary , Famciclovir/therapeutic use , Antiviral Agents/therapeutic use , Viremia/veterinaryABSTRACT
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