Clinical features of atypical presentations of mucocutaneous herpes simplex virus infection observed in immunosuppressed individuals. Part I: herpetic geometric glossitis.

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.

Isolation of Avipoxvirus from Tongue of Canaries ( Serinus canaria) Show Severe Localized Proliferative Glossitis.

Poxvirus was the causative agent of two unusual outbreaks of proliferative glossitis in canary ( Serinus canaria forma domestica) breeders in the Northern Italy. A total of 45, 7-9-mo-old canaries were submitted in fair postmortem conditions to the Istituto Zooprofilattico Sperimentale delle Venezie at the beginning of November 2005 for diagnostic investigation. Birds belonged to two unrelated and geographically distant aviaries in northern Italy, herein identified as Aviary A and Aviary B. The two breeder flocks had both attended the same bird exposition held at the beginning of October and started experiencing an onset of high mortality 3 wk after the show. Twelve red factor-melanin canaries from Aviary A (Mantua) and 33 dominant white and recessive white canaries from Aviary B (Vicenza) were submitted for laboratory investigations. Clinical signs were unspecific and consisted of depression, ruffling of the feathers, epistaxis, and anorexia due to decreased feed and water intake. Postmortem findings revealed a severe increase in volume, thickening, and hardening of the tongue, which had turned pinkish to dark brown. No apparent gross lesions were noticed in integumentary, respiratory, and digestive systems or other internal organs. Histopathologic evaluation of the tongue revealed severe proliferation of the stratified squamous epithelium containing numerous large eosinophilic intracytoplasmic inclusion bodies (Bollinger bodies) displacing the nuclei of the cells peripherally. Severe ulceration of the surface epithelium, fibrinoheterophilic plaque formation, and moderate basal lymphoplasmacytic infiltrations were also associated with the proliferative lesion. Poxvirus was successfully isolated from the lesions in tissue cultures but not in specific-pathogen-free chicken embryonated eggs. Typical large, brick-shaped viral particles of 300-450 nm were also observed in affected tongues by transmission electron microscopy. This is the first report of multiple outbreaks of "poxvirus glossitis" in canaries.

Human papilloma virus in oral mucosa and its association with periodontal status of gynecologically infected women.

The aim of this study was to determine whether Human Papillomavirus was present in tongue and periodontium of periodontally healthy and diseased women who had genital lesions caused by the virus. Thirty non-menopausal women, systemically healthy and diagnosed with gynecological HPV lesions, were referred by the Gynecology Service Department of the University Maternal Neonatal Hospital of the City of Cordoba. Anamnesis, oral mucosa examination and periodontal clinical assessment were performed. Three brush samples were taken per patient: two from the same periodontal location (external epithelium of the gum and internal epithelium of the periodontal sulcus/pocket), and the third from the tongue. The 90 samples were submitted to Pap cytology and Polymerase Chain Reaction. The data were statistically analyzed by "Chi Square Test" (χ2) and "Kappa Index" (κ). High prevalence of HPV was found in the tongue (30%) and periodontal tissues (15%). High risk (HR) genotype -16 was detected with the highest percentage (67%), and genotypes -52 and -6 were also detected. Whenever HPV was present in periodontal location, it was also identified in the tongue of the same patients, of whom 88.89% reported that they practiced oral sex. Is worth noting the clinical finding of stomatologic lesions compatible with foliate papillitis in patients with positive intraoral HPV. High prevalence of HPV was found in the female population in Cordoba, with genotype -16 being detected at the highest percentage. No positive correlation was found between HPV and higher incidence and severity of periodontal lesions.

Transient lingual papillitis associated with confirmed herpes simplex virus 1 in a patient with kawasaki disease.

We present a case of transient lingual papillitis associated with confirmed herpes simplex virus 1 that developed after a child received intravenous immunoglobulin and infliximab for acute Kawasaki disease.

[Glossitis by mixed infection of cytomegalovirus and herpes simplex virus during therapy for pure red cell aplasia complicated with Good syndrome].

A 64-year-old man with a 10-year history of Good syndrome had been treated with periodic replacement of γ-globulin. He also had a 6-year history of lichen planus of the tongue. In 2009, the patient was diagnosed as having pure red cell aplasia (PRCA) based on bone marrow aspiration. Thymectomy was not effective. Then, immunosuppressive therapy with PSL and cyclosporine was initiated. Twenty days after treatment painful ulcer appeared on the left side of the tongue. Biopsy specimen of the ulcer demonstrated cells infected with cytomegalovirus and herpes simplex virus. Cytomegalovirus antigenemia was also positive. The tongue ulcer promptly improved after gancyclovir administration for a few weeks. Viral glossitis should be considered as part of the differential diagnoses of oral lesions not only in patients with HIV infection but also in those under immunosuppressive therapy.

Herpetic geometric glossitis: acyclovir resistant case in a patient with acute myelogenous leukemia.

Herpes simplex virus (HSV) infections in an immunocompromised host may be atypical in location and morphology. Lesions are more extensive and aggressive, slow healing or nonhealing and extremely painful. Intraoral lesions are ulcerative and may involve any intraoral, oropharyngeal, or esophageal site. Herpetic geometric glossitis is a recently described form of lingual HSV infection in an immunocompromised patient. It was described as ulcer on the dorsum of the tongue sensitive for acyclovir therapy. A patient is presented with acute myelogenous leukemia that developed herpetic geometric glossitis which was acyclovir resistant.