Herpetic tracheitis and polybacterial pneumonia in an immunocompetent young man is herpes tracheitis involved in the pathogenesis of bacterial pneumonia?

ABSTRACT

We report a 28-year-old immunocompetent man that after a course of corticoids developed a severe pneumonia in right lower lobe. A fiber-optic bronchoscopy showed a white membrane easily bloody on contact with bronchoscopy tube at trachea level. The tracheal biopsy showed typical cytopathological lesions of herpes simplex virus (HSV) and polymerase chain reaction was positive for type 1 HSV. Streptococcus viridans and Fusobacterium necrophorum grew in right bronchial secretion cultures. Clinical improvement was achieved after prolonged antibiotic therapy and before initiating treatment with acyclovir. Herpetic tracheitis could have been involved in the aspiration of oropharyngeal material that leaded to the development of this bacterial pneumonia.