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A case report of tracheobronchitis by herpes simplex virus, type I.

Kim DS, Kim SJ, Lee YW, Hong SR, Ko IH - Korean J. Intern. Med. (1986)

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ABSTRACT

Herpes simplex virus (HSV) infection of the lung and lower respiratory tract has been thought to be a rare and fatal disease, usually in patients with immunosuppression, severe burns, or prolonged intubation. However, recently, increasing numbers of patients have been reported to have a localized infection and some of them have recovered without specific therapy.

In Korea, there has been yet no proven case of HSV infection of the lower respiratory tract. Recently, we saw a case of localized HSV infection of the tracheobronchus. A 78-year-old male patient was admitted in acute respiratory failure, with COPD and old pulmonary trberculosis. After the clinical condition improved, a bronchoscopy was done which revealed a localized area of swelling, hyperemia, and mucosal irregularity at the lower trachea and right upper lobar bronchus. Bronchial brushing and biopsy showed typical cytologic changes including intranuclear inclusion body. Viral culture of a bronchial washing revealed a growth of HSV, type I. The patient died of unrelated, acute myocardial linfarction.

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Histopathologic finding of the bronchoscopic biopsy. Severe necrotic inflammation is found with squamous metaplasia. Many of the cells show typical cytologic change seen in Fig. 3 at the high power view. (Hematoxylin and eosin stain, ×100).
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f4-kjim-1-2-249-18: Histopathologic finding of the bronchoscopic biopsy. Severe necrotic inflammation is found with squamous metaplasia. Many of the cells show typical cytologic change seen in Fig. 3 at the high power view. (Hematoxylin and eosin stain, ×100).

Mentions: Six sputum smears for AFB were all negative. The patient improved with 2L/minute O2 inhalation, antibiotics (cephalosporin and gentamicin), brochodilatiors, and chest physiotherapy. On the 6th hospital day, fiberotic bronchoscopy was performed for the investigation of the lesion of the right upper lung. It revealed a localized area of swelling and hyperemia on the right lateral wall of the lower trachea, extending to the proximal part of right upper bronchus. No definite blister or ulceration was found, but several discrete nodules were noticecd (Fig. 2). At the cytologic study of broncheal brushing and washing, typical findings of HSV infection were observed : nuclei showed a ground-glass appearance with small, clear vacuoles, granular distribution of chromatin along the nuclear membrane, typical intra-nuclear eosinophilic inclusion bodies, and many, multinucleated ginat cells (Fig. 3). Bronchoscopic biopsy revealed severe necrotic inflammation with squamous metaplasia, and the cytologic changes typical of HSV, which were mentioned earlier (Fig. 4). Three days later a repeated bronchoscopy was done to obtain material for culture, and this time, whitish pseudomembrane was found to cover the inflamed area (Fig. 5). Viral culture by the inoculation of the bronchial washing into Vero Cells (monkey kidney cells) with medium-199 at the Korean National Institute of Health resulted in the growth of HSV type I.


A case report of tracheobronchitis by herpes simplex virus, type I.

Kim DS, Kim SJ, Lee YW, Hong SR, Ko IH - Korean J. Intern. Med. (1986)

Histopathologic finding of the bronchoscopic biopsy. Severe necrotic inflammation is found with squamous metaplasia. Many of the cells show typical cytologic change seen in Fig. 3 at the high power view. (Hematoxylin and eosin stain, ×100).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536714&req=5

f4-kjim-1-2-249-18: Histopathologic finding of the bronchoscopic biopsy. Severe necrotic inflammation is found with squamous metaplasia. Many of the cells show typical cytologic change seen in Fig. 3 at the high power view. (Hematoxylin and eosin stain, ×100).
Mentions: Six sputum smears for AFB were all negative. The patient improved with 2L/minute O2 inhalation, antibiotics (cephalosporin and gentamicin), brochodilatiors, and chest physiotherapy. On the 6th hospital day, fiberotic bronchoscopy was performed for the investigation of the lesion of the right upper lung. It revealed a localized area of swelling and hyperemia on the right lateral wall of the lower trachea, extending to the proximal part of right upper bronchus. No definite blister or ulceration was found, but several discrete nodules were noticecd (Fig. 2). At the cytologic study of broncheal brushing and washing, typical findings of HSV infection were observed : nuclei showed a ground-glass appearance with small, clear vacuoles, granular distribution of chromatin along the nuclear membrane, typical intra-nuclear eosinophilic inclusion bodies, and many, multinucleated ginat cells (Fig. 3). Bronchoscopic biopsy revealed severe necrotic inflammation with squamous metaplasia, and the cytologic changes typical of HSV, which were mentioned earlier (Fig. 4). Three days later a repeated bronchoscopy was done to obtain material for culture, and this time, whitish pseudomembrane was found to cover the inflamed area (Fig. 5). Viral culture by the inoculation of the bronchial washing into Vero Cells (monkey kidney cells) with medium-199 at the Korean National Institute of Health resulted in the growth of HSV type I.

View Article: PubMed Central - PubMed

ABSTRACT

Herpes simplex virus (HSV) infection of the lung and lower respiratory tract has been thought to be a rare and fatal disease, usually in patients with immunosuppression, severe burns, or prolonged intubation. However, recently, increasing numbers of patients have been reported to have a localized infection and some of them have recovered without specific therapy.

In Korea, there has been yet no proven case of HSV infection of the lower respiratory tract. Recently, we saw a case of localized HSV infection of the tracheobronchus. A 78-year-old male patient was admitted in acute respiratory failure, with COPD and old pulmonary trberculosis. After the clinical condition improved, a bronchoscopy was done which revealed a localized area of swelling, hyperemia, and mucosal irregularity at the lower trachea and right upper lobar bronchus. Bronchial brushing and biopsy showed typical cytologic changes including intranuclear inclusion body. Viral culture of a bronchial washing revealed a growth of HSV, type I. The patient died of unrelated, acute myocardial linfarction.

Show MeSH
Related in: MedlinePlus