1/102. Disseminated herpes simplex virus infection in a renal transplant patient as possible cause of repeated urinary extravasations.Disseminated herpes simplex virus type 2 (HSV-2) infections are infrequent in patients receiving organ transplants, but usually have a poor outcome. We describe the case of a renal transplant patient who developed a disseminated HSV-2 infection with repeated urinary extravasations. The diagnosis was carried out using a multiplex polymerase chain reaction nested assay and it suggested HSV-2 as a possible cause of repeated urinary fistulas.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/102. Sequential peripartum herpes simplex virus type 2 disease in parents and their newborn mimicking intrafamily spread of common viruses.herpes simplex type 2 (HSV2) disease developed sequentially among two parents and their newborn. The father first became ill with upper-respiratory symptoms and fever. Then, 5 days later, shortly after delivery, the mother had fever, pharyngitis, and diarrhea. Subsequently, the infant developed undifferentiated febrile illness at the age of 3 days. HSV etiology was recognized by incidental isolation of HSV2 from the newborn naospharynx. The father never developed genital lesions and the mother's symptoms remained nonspecific for several days prior to the onset of genital manifestations. The sequential emergence and manifestations of these infections could have been misconstrued for an intrafamily spread of respiratory or enteric viruses. This cluster illustrates that HSV2 may cause sequential symptomatic disease in susceptible individuals mimicking other viruses.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
3/102. Aseptic herpetic meningitis: an uncommon genital herpes sequelae.Aseptic herpetic meningitis is a clinical syndrome characterized by fever, headaches, confusion, and a combination of meningeal signs. The spinal fluid findings consist of an increase in mononuclear cells (mononuclear pleocytosis), increased protein concentration, and normal glucose concentrations. Aseptic herpetic meningitis is thought to be caused by a viral infection, although the specific virus is usually not demonstrated. The condition is self-limited and requires no treatment.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
4/102. Atypical presentation of herpes simplex virus in a patient with chronic lymphocytic leukemia.Perianal infections caused by herpes simplex virus are common in immunocompromised patients. The cutaneous presentation in these patients is often atypical, overlaps with the clinical features of other diseases, poses a difficulty in diagnosis, and responds poorly to treatment. An immunocompromised patient with chronic lymphocytic leukemia, treated with oral corticosteroids, presented with chronic perianal ulcerations. This patient was referred for evaluation and treatment of "recalcitrant" pyoderma gangrenosum. Prompt diagnosis was possible when the clinical features were recognized and appropriate biopsy and cultures were obtained. We describe an atypical presentation of herpes simplex virus associated with both an endogenous and exogenous induced immunodeficiency, and stress the importance of routinely performing cultures on all perianal ulcerations and anal fissures to avoid the misdiagnosis, inappropriate treatment, and prolonged discomfort of these afflicted patients.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
5/102. Identification and treatment of herpes lesions.Infections caused by the herpes family of viruses are on the rise. Mucocutaneous herpes infections are caused by herpes simplex viruses 1 and 2 and varicella-zoster virus. herpes simplex virus commonly causes oral-labial or genital infection, and varicella-zoster virus causes chicken pox and shingles. Clinical features frequently are atypical, particularly in compromised patients. Therefore, a high index of suspicion must be maintained for early diagnosis. Availability of easy-to-perform rapid diagnostic tests and several potent antiherpetic agents have vastly improved the management of herpes infections.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
6/102. Procalcitonin may help differentiate disseminated herpes simplex viral infection from bacterial sepsis in neonates.Disseminated herpes simplex virus infection is a potentially fatal condition which may be difficult to differentiate from bacterial sepsis. We report the case of a neonate with overwhelming herpes simplex (type 2) viraemia who presented with 'septic shock'. CONCLUSION: A low procalcitonin level (1.6 ng/ml), inconsistent with bacteraemia, suggests an alternative aetiology and may strengthen the case for antiviral therapy.- - - - - - - - - - ranking = 0.83333333333333keywords = infection (Clic here for more details about this article) |
7/102. herpes simplex type 2 causing fulminant hepatic failure.Although exceedingly rare, fulminant hepatic failure (FHF) in immunocompetent patients can develop with primary or recurrent infection due to herpes simplex virus (HSV). The diagnosis is frequently obscured by the absence of mucocutaneous involvement. Elevated transaminase values with leukopenia and a relatively low bilirubin level may provide clues to the diagnosis. We describe an immunocompetent woman who died of FHF before a definitive diagnosis of HSV type 2 hepatitis was established. herpes simplex virus hepatitis is one of the few causes of FHF for which potentially effective therapy is available. Thus, early diagnosis is paramount and usually requires liver biopsy. Recent studies suggest that transjugular liver biopsy is safe and effective in establishing the cause of FHF. Since the diagnosis and management of FHF are frequently influenced by the results of transjugular liver biopsy, it may become a standard diagnostic tool for managing FHF in centers where such expertise exists.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
8/102. Recurrent lumbosacral herpes simplex in the bedridden hospitalized patient.A clinical variant of genital herpes simplex virus (HSV) infection, recurrent lumbosacral HSV, occurs in bedridden hospitalized patients. We want to call attention to an uncommon pattern of HSV infection in the hospitalized bedridden patient seen by the dermatology consultation service in a large university hospital. HSV is characterized by a mixture of recurrent groups of herpetic vesicles in all stages of development, with multiple, persistent hyperpigmented patches bilaterally distributed over the lumbosacral (buttocks) area.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
9/102. Diagnostic and therapeutic dilemmas of a large scrotal lesion in an AIDS patient.In the setting of hiv infection, chronic genital ulcerations may be challenging both diagnostically and therapeutically. The differential diagnosis of these lesions is very broad, and the causes can be multifactorial. We present a case of a chronic, extensive, ulcerating scrotal mass and review the salient clinical, diagnostic, and therapeutic considerations.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
10/102. Chronic erosive herpes simplex virus infection of the penis, a possible immune reconstitution disease.OBJECTIVE: To report a novel clinical presentation: a chronic erosive herpes simplex virus (HSV) infection of the penis which developed in AIDS patients following the commencement of highly active antiretroviral therapy (HAART). The lesions were unresponsive to antiviral treatments which had previously been effective, and this could not be accounted for in terms of increased antiviral resistance. DESIGN: Detailed case-note review and investigation of three cases which presented at two large hiv units in london. methods: review of all histology with immunohistochemistry for HSV, HSV drug susceptibility assays, tissue typing and measurement of in vitro lymphocyte functional activity against HSV. RESULTS: The histology of the lesions was the same in each case, with the presence of HSV on immunohistochemistry and an unusual prominence of plasma cell and eosinophils in the inflammatory infiltrate. HSV-specific lymphoproliferative responses were normal in two cases, but subnormal in a third case. All individuals shared the HLA class I molecules B72 and Cw0202 and the class II allele DRB4. CONCLUSION: We believe this to be a previously unreported adverse consequence of HAART, the result of partial immune restoration, reminiscent of the the recently described syndrome of immune recovery vitritis.- - - - - - - - - - ranking = 0.83333333333333keywords = infection (Clic here for more details about this article) |
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