1/27. Chronic herpes simplex virus type I glossitis in an immunocompromised man.herpes simplex virus (HSV) type 1 (HSV-1) infection of the tongue commonly accompanies acute primary herpetic gingivostomatitis. However, recurrent infection of the tongue is exceptional and is restricted to immunocompromised individuals. A 57-year-old man with corticosteroid-dependent chronic obstructive pulmonary disease and sciatica presented with a chronic median glossitis due to HSV-1. The main clinical and histological feature was massive necrosis of the entire mucosa. immunohistochemistry demonstrated a considerable amount of HSV gB, gC and gD envelope glycoproteins dispersed in the chorion. In contrast, HSV-1 dna was detected only in a limited number of epithelial cells using in situ hybridization. The extent of necrosis and the pattern of viral dna and envelope protein distribution represent unique features of median herpetic glossitis, which are not found in more common types of HSV infection.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
2/27. adult-onset herpes simplex virus hepatitis with diffuse myofibroblastic transformation of hepatic stellate cells (Ito cells) in non-necrotic areas.The myofibroblastic transformation of hepatic stellate cells (HSC; also known as Ito cells) usually occurs following necrosis of adjacent liver cells. No report has previously found that such a transformation occurs in herpes simplex virus (HSV) hepatitis. We present an autopsy case of HSV hepatitis with myofibroblastic transformation of HSC that is different from the usual transformation of HSC. The patient was a 66-year-old woman who had received various therapies for cutaneous T-cell lymphoma. An autopsy revealed submassive hepatic necrosis with hemorrhage due to HSV hepatitis. HSV infection was confirmed by dna in situ hybridization in liver tissue. Immunohistochemical staining for alpha-smooth muscle actin (ASMA) showed a strong positive reaction in almost all of the HSC in non-necrotic areas. However, in necrotic areas, the HSC were completely negative for ASMA. These findings indicate that not only liver cells but also HSC can become necrotic in HSV hepatitis. In contrast, in non-necrotic areas, almost all of the HSC showed active transformation to myofibroblasts.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
3/27. Successful treatment of an aciclovir-resistant herpes simplex type 2 infection with cidofovir in an AIDS patient.Management of the increasing frequency of aciclovir-resistant herpes simplex virus (HSV) infections among immunocompromised human immunodeficiency virus-infected people demands additional treatment options. We report the case of a 38-year-old patient with acquired immune deficiency syndrome who suffered from a perianal butterfly ulcer, which was HSV-2 positive by polymerase chain reaction (PCR) analysis. The ulcer appeared during treatment of a cytomegalovirus (CMV) pneumonitis with ganciclovir. Despite additional valaciclovir therapy the lesion gradually progressed in size. Investigations including histology, PCR analysis and in situ hybridization of a biopsy from the growing ulcer margin confirmed the presence of HSV-2 infection. Importantly, HSV isolates from this specimen were resistant to aciclovir. Based on a report about the successful treatment of aciclovir-resistant HSV infection with cidofovir, our patient received this drug intravenously at a dose of 5 mg kg-1 body weight once weekly for a total of 3 weeks. Concomitant oral probenecid and prehydration were administered to minimize nephrotoxicity. Within 30 days of treatment the ulcer had almost (> 95%) completely healed. We conclude that cidofovir is a potent antiviral drug with a potential usefulness in the treatment of aciclovir-resistant HSV-2 infection. It deserves further investigation in clinical trials.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
4/27. Florid CD4 , CD56 T-cell infiltrate associated with herpes simplex infection simulating nasal NK-/T-cell lymphoma.We report a case of herpes simplex virus (HSV) infection of the nasopharynx associated with a dense CD4 , CD56 T-cell infiltrate that simulated lymphoma on clinical, histologic, and immunophenotypic grounds. Histologic examination showed a tumorlike lymphoid infiltrate with extensive necrosis. Multinucleated giant cells with "ground-glass" nuclei characteristic of HSV were observed in necrotic areas but were not prominent. Immunohistochemical studies of the lymphoid infiltrate revealed a predominance of T cells, positive for CD3, CD4, CD5, and CD56. Immunohistochemical staining with HSV antibody was focally positive in the multinucleated giant cells. Molecular studies using PCR and Southern blot were positive for HSV Type II. PCR studies for T-cell receptor gamma and immunoglobulin heavy chain gene rearrangements showed no evidence of a clonal population. in situ hybridization studies for Epstein-Barr virus (EBV) were negative. The clinical presentation of a large fungating mass, the extent of the lymphoid infiltrate, and the expression of CD56 all raised the possibility of a nasal NK/T cell lymphoma. However, the presence of HSV, lack of angioinvasion and angiodestruction, absence of EBV, and polyclonal T-cell nature of the infiltrate argued against this diagnosis. Although prior studies have not fully characterized the immunophenotypic features of the lymphocyte response to HSV in infected tissues, we postulate that the CD56 , CD4 T-cell reaction represents a florid antiviral immune response.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
5/27. herpes simplex hepatitis before and after acyclovir treatment. Immunohistochemical and in situ hybridization study.A healthy 20-year-old woman developed herpes simplex virus (HSV) hepatitis. The diagnosis was made by needle biopsy of the liver, and the patient was intravenously treated with acyclovir for 15 consecutive days (total dose, 21 g). The liver biopsy specimen and liver tissue obtained at autopsy were processed for immunoperoxidase staining with rabbit anti-HSV and for dna-dna in situ hybridization. The liver biopsy tissue revealed massive necrosis of hepatocytes, which were strongly positive for HSV with both immunoperoxidase and in situ hybridization methods. The liver tissue obtained at autopsy showed regenerative nodules of hepatocytes, surrounded by connective tissue stroma. Within the connective tissue there were completely necrotic hepatocytes, which were positive for HSV with the immunoperoxidase method but almost completely negative with the in situ hybridization method, except for a very few HSV dna-positive hepatocytic nuclei. It was concluded that immunoperoxidase staining with anti-HSV is a sensitive method with which to detect ongoing and previous HSV infection, whereas the in situ hybridization method is specific for HSV-dna from viable HSV.- - - - - - - - - - ranking = 8keywords = hybridization (Clic here for more details about this article) |
6/27. herpes simplex virus type II infection of ileum mesothelium: a case report and review of the literature.Disseminated herpes simplex virus (HSV) infection usually manifests in the immunocompromised. However, anecdotal examples of visceral HSV disease and viremia have complicated type I diabetes. A case of a 53-year-old type I diabetic patient with bowel obstruction one week subsequent to bronchitis is reported. At laparotomy, a perforated segment of ileum was associated with an adhesive peritoneal band. HSV cytopathic atypia and HSV immunohistochemical staining were confined to fibrocytes and mesothelial cells without involvement of the epithelium. Dissemination of symptomatic HSV pneumonia was verified by histology, immunohistochemistry, in situ hybridization, polymerase chain reaction and direct fluorescence antibody. Intravenous acyclovir resolved symptoms. This is a novel documentation of HSV complicating ileal adhesive band disease. Furthermore, this case indicates that the HSV cytopathic effect is not unique to the epithelium. Disseminated infection can manifest in myofibrocytes and mesothelium, distinguishing it from standard epithelial atypia of localized HSV infection.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
7/27. Acute retinal necrosis diagnosed in a child with chronic panuveitis.BACKGROUND: To report the case of an immunocompetent child with herpes simplex virus-2 (HSV-2) acute retinal necrosis (ARN) syndrome, who was considered to have an idiopathic unilateral panuveitis sensitive to steroid treatment. methods: polymerase chain reaction for detection of viral dna was applied to ocular fluids and in situ hybridization was performed on a retinal sample. HSV serology was performed using the ELISA and Western blot techniques, and an in-house indirect immunofluorescence technique. RESULTS: In addition to the atypical clinical presentation, the serological assays for HSV were negative using ELISA at the time of diagnosis of ARN and 1 year after. HSV2 infection was confirmed by using polymerase chain reaction of aqueous humor specimen and in situ hybridization of a retinal biopsy. Retrospective analysis with the Western blot technique detected low titers of anti-HSV antibodies, when the sera were concentrated 5-fold. CONCLUSION: Herpes virus infections must be investigated in children with posterior or panuveitis. PCR analysis is a reliable technique for diagnosis. This case emphasizes that clinical presentation can be atypical and that a negative viral serology does not exclude an acute or a past herpetic infection.- - - - - - - - - - ranking = 2keywords = hybridization (Clic here for more details about this article) |
8/27. Pathological features of virus infections of the central nervous system (CNS) in the acquired immunodeficiency syndrome (AIDS).Neurological disorders are a common cause of morbidity and mortality in the acquired immunodeficiency syndrome (AIDS). In this report we describe the neuropathological changes associated with both human immunodeficiency virus (hiv) infection and with the major opportunistic virus infections, cytomegalovirus (CMV), JC papovavirus (JCV) and herpes simplex virus (HSV) seen in AIDS. In addition "in situ" hybridization studies have been employed for the detection of virus genomic material in each case and the usefulness of this method in supporting the pathological diagnosis is demonstrated. Mechanisms whereby hiv infection results in leukoencephalopathy and the possible contributing roles of the three opportunistic virus infections are discussed.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
9/27. Concurrent epidermal involvement of cytomegalovirus and herpes simplex virus in two hiv-infected patients. Military Medical Consortium for Applied Retroviral research (MMCARR).Although cytomegalovirus has previously been reported in cutaneous lesions of patients infected with the human immunodeficiency virus, these reports are not common despite the prevalence of this infection and the significant pathologic characteristics that it induces in hiv disease. Rare reports of possible epidermal involvement by cytomegalovirus have never been fully documented and have been believed by some to represent epidermal involvement by varicella-zoster and/or herpes simplex infections, with dermal involvement of cytomegalovirus. We present two cases of concurrent epidermal involvement by cytomegalovirus and herpes simplex virus documented by immunohistochemical studies and dna hybridization studies and correlate this with the distinctive morphologic features seen in these two viral infections on routine staining.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
10/27. Evolution of post-natal herpes simplex virus encephalitis to multicystic encephalopathy.A 3-week-old, previously healthy infant developed biopsy-proven Herpes virus type 2 (HSV-2) encephalitis. The encephalitis was characterized by cells having intranuclear inclusions and was without evidence of inflammation or hemorrhage. neuroimaging studies did not show any destructive lesions in the brain. In spite of antiviral therapy, the infant's neurological conditions deteriorated, and the patient died at the age of 18 weeks. Post-mortem examination showed that most of the cerebral hemispheres were replaced by multiloculated cystic cavities of various sizes, typical of multicystic encephalopathy (MCE). The cystic lesions were randomly distributed and were not confined to any vascular territory. By light microscopy, there were no features of viral infection in the brain. Although in situ hybridization of the biopsy specimen taken during the acute phase of the disease demonstrated abundant HSV genome, this same method failed to detect HSV on the post-mortem specimen. These findings suggest that HSV-2 can induce MCE. Furthermore, the absence of histological features of viral encephalitis and the failure to demonstrate viral genome in the brain at autopsy does not exclude an infectious etiology in certain cases of MCE.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
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