Abstract
An autopsy review covering a 10 year period revealed 56 adult patients with histocytologic evidence of herpesvirus (herpes simplex or varicella-zoster) infection involving nongenital viscera. Review of the clinical records of these patients disclosed that herpesvirus infections were clinically suspected in only seven of them: three patients with cutaneous herpes zoster, two patients with herpetic keratitis and two patients with gingivostomatitis. Nine additional patients also had ulcerative gingivostomatitis, but this was attributed to either fungal organisms or chemotherapy. Forty patients showed no apparent clinical signs or symptoms of herpetic infection. Visceral involvement was not suspected clinically in any of the 56 patients. The most common underlying disease process afflicting these patients was a malignant neoplasm, usually involving the hematopoietic or lymphoreticular systems, but almost one-third had a variety of nonmalignant diseases. The presence of an associated infectious process involving bacterial, fungal or protozoal organisms, or additional viral agents, was confirmed by culture studies or autopsy microscopic findings in all but two patients. The viscus most commonly involved by herpetic infection was the esophagus. Herpetic esophageal ulcers were found in 50 cases, and in 41 cases no other organs appeared involved. Because esophageal ulcers are usually asymptomatic, antemortem diagnosis is extremely difficult. The data derived from this and previous studies indicate that herpetic ulcers frequently become secondarily infected with bacteria and/or fungi and that the greatest clinical significance of these ulcers is as a site of secondary infection, particularly in patients who have undergone immunosuppression (immunosuppressed patients). The advent of effective antiherpesvirus drugs and greater clinical awareness of the disease should serve as a stimulus to establish a clinical diagnosis of visceral herpesvirus infection more frequently.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.