Dissemination Of Herpes Simplex Virus Research Articles

Herpes simplex virus dissemination with necrotizing hepatitis following Descemet membrane endothelial keratoplasty

BackgroundCorneal transplants are the most common type of transplant and increasing in frequency. Donor cornea tissues are a rare source of herpes simplex virus (HSV) transmission and not routinely tested for presence of HSV. Donor graft-to-recipient transmission typically causes graft failure and anterior uveitis, and extra-ocular HSV disease has not been previously reported. We present a case of HSV transmission from donor cornea tissue that nearly cost the corneal transplant recipient his life.Case reportAn elderly immunocompetent man developed an acute illness 10 days after having donor corneal tissue implanted in a Descemet membrane endothelial keratoplasty (DMEK). He was found to have HSV necrotizing hepatitis per liver biopsy, trilineage cytopenia, rhabdomyolysis, acute kidney failure, altered mental status, early-stage hemophagocytic lymphohistiocytosis (HLH), and donor corneal tissue implant infection resulting in graft failure and anterior uveitis. HSV DNA was detected in cerebral spinal fluid, peripheral blood, explanted donor corneal tissue, and anterior chamber fluid (220 million HSV DNA copies per mL). HSV-1 seroconversion denoted a primary HSV infection, and the patient had no other risk factor for HSV acquisition. Early recognition of HSV dissemination prompting treatment with intravenous acyclovir, as well as a short course of HLH-directed therapy, resolved the systemic illness. Vision was restored to near normal by replacement of the infected corneal graft with new donor DMEK tissue in conjunction with intravitreal foscarnet treatment.ConclusionAwareness of the potential risk of donor cornea tissue transmitting HSV and leading to life-threatening HSV disease is paramount to early diagnosis and treatment. The role of donor cornea tissue in HSV transmission and disease merits additional attention and investigation.

Topical Corticosteroids and Hospital Length of Stay in Children with Eczema Herpeticum

There is concern that the use of topical corticosteroids in patients with eczema herpeticum may facilitate dissemination of herpes simplex virus and worsen disease. Our primary aim therefore was to determine whether topical corticosteroid use in children hospitalized with eczema herpeticum is associated with longer hospital length of stay (LOS). We performed a multicenter retrospective cohort study of 1,331 children ages 2 months to 17 years admitted with a diagnosis of eczema herpeticum between January 1, 2001, and March 31, 2010, to 42 tertiary care children's hospitals in the Pediatric Health Information System database. Multivariable linear regression models determined the association between receipt of topical corticosteroid therapy on the first day of hospitalization and the main outcome measure: LOS. Receipt of topical corticosteroid therapy on day 1 of hospitalization was not associated with a longer LOS on unadjusted or multivariable analysis (p = 0.75). Receipt of topical calcineurin inhibitors during the hospitalization was also not associated with a longer LOS (p = 0.12). Receipt of systemic corticosteroids was associated with an 18% adjusted longer LOS (95% confidence interval 2%-36%; p = 0.03). Further study is needed to identify which children with eczema herpeticum may benefit from topical corticosteroids, but their use during active infection is not associated with poorer outcomes, although the use of systemic corticosteroids was associated with a longer LOS and should be avoided in patients with eczema herpeticum pending future prospective study.

Disseminated mucocutaneous herpes simplex virus infection in an immunocompetent woman

Disseminated mucocutaneous herpes simplex virus (HSV) infection in an immunocompetent person is quite rare. A 19-year-old healthy Japanese woman presented with painful, umbilicated vesicles and pustules on her genital region, both nipples and on the forearm 10 days after the last sexual contact with her partner who had cold sore at that time. Tzanck test and biopsy confirmed the diagnosis of disseminated mucocutaneous HSV infection. She did not have any visceral HSV disease. Skin lesions improved after treatment with acyclovir and erythromycin for seven days. We propose that like herpes gladiatorum, HSV dissemination in this case was acquired by close body contact.

Eccema herpético por virus herpes simplex tipo 2: Revisión de la literatura a propósito de un caso

Eczema herpeticum is an extensive vesicular eruption caused by cutaneous dissemination of herpes simplex virus in patients who have underlying skin conditions or epidermal barrier disruption. Herpes simplex virus type 1 (HSV 1) is the most common etiology. This is the first report in Chile of a case of eczema herpeticum caused by HSV 2 in a patient with Darier's disease, We review the literature and emphasize the use of sensitive and specific assays as real time polymerase chain reaction, that allow to initiate timely the correct treatment.

A Case of Eczema Herpeticum with Hailey-Hailey Disease

Eczema herpeticum is the dissemination of herpes simplex virus in the setting of a preexisting skin disease. Hailey-Hailey disease [familial benign chronic pemphigus] is a blistering dermatosis that is inherited as an autosomal dominant trait and it usually presents itself around the third or fourth decades. Coexistence of eczema herpeticum and Hailey-Hailey disease is an infrequent occurrence. Four such cases have been reported in the English and German medical literature. We report here on an unusual case of eczema herpeticum that coexisted with Hailey-Hailey disease in a 47 years old man and we review the relevant literatures.

Eczema Herpeticum: Making the diagnosis in the Emergency Department

Eczema herpeticum (EH), a form of Kaposi's varicelliform eruption, is the dissemination of herpes simplex virus in the setting of preexisting eczema. We discuss the case of an 18-year-old woman with underlying atopic dermatitis (AD) who presented to an Emergency Department complaining of malaise, fever, and a spreading, burning, vesiculopapular facial rash. She was treated for both presumed impetigo and a flare of her underlying AD with cephalexin, bacitracin ointment, topical steroids, and diphenhydramine. Her condition worsened, and she was seen 3 days later by her primary care physician, who recognized the superimposition of a herpetic infection on her underlying AD and revised the diagnosis to EH. An oral regimen of acyclovir led to prompt resolution of the patient's rash and symptoms. Recognition of EH in the acute care setting is essential for the provision of timely and specific treatment and to avoid the serious sequelae of this condition.

Two paths for dissemination of Herpes simplex virus from infected trigeminal ganglion to the murine cornea

Herpes simplex virus type 1 (HSV) was introduced into the mouse trigeminal ganglion by stereotaxic injection. We examined the form in which the virus was transported anterograde within axons and the spread of virus to glial and endoneurial cells of the nerve using EM immunocytochemistry. Our results indicate that viral dissemination in the trigeminal nerve may occur both within the axon and in the extracellular space of the endoneurium. HSV is intraaxonally transported at least in part as a nucleocapsid, i.e., with neither viral envelope nor additional cellular membranes. Schwann cells are infected as a result of spread in the endoneurium, as well as by nearby axons.

Detection of Herpes simplex Virus DNA in Non-Herpetic Areas of Patients with Eczema herpeticum

Background: Patients with atopic dermatitis may develop a widespread cutaneous herpes simplex virus (HSV) infection called eczema herpeticum. Objective: We examined the possible routes of indirect HSV dissemination in 10 patients with eczema herpeticum, although direct spread of HSV is the most likely route of infection. Methods: Specimens were collected from hands and ‘non-herpetic’ areas (i.e. without eczema herpeticum), with or without eczematous and/or erythematous lesions of atopic dermatitis, of 10 patients with eczema herpeticum. We tried to detect HSV DNA in the samples by polymerase chain reaction. Results: HSV DNA was frequently detected on both hands and on cutaneous surfaces clinically free of eczema herpeticum. These patients had scratched such lesions because of itching. Moreover, they had taken baths the day before the examination. Conclusion: These results suggest that there may be two routes of indirect transmission of this virus, namely via manual scratching of herpetic lesions or via a contaminated bath towel or item of underwear.

Herpes simplex virus tracheitis in a patient with the acquired immunodeficiency syndrome

Herpetic tracheobronchitis and pneumonia occur basically in immunodepressed patients, but have rarely been reported in patients with the acquired immunodeficiency syndrome (AIDS). Some large reviews on pulmonary manifestations in AIDS report a small number of herpetic pulmonary infections, without determining any prevalence of this particular viral involvement. Predisposing factors are alteration of cell-mediated immunity and invasive procedures (such as endotracheal tube use) in debilitated patients. The case we report illustrates the occurrence of a herpetic tracheitis in an HIV-infected patient with severe P. carinii pneumonia, needing systemic corticotherapy and mechanical ventilation. It illustrates the risk of dissemination of herpes simplex virus (HSV) from a herpetic stomatitis to the lower respiratory tract, even after the endotracheal cannula has been removed.

A long-term prospective clinical study of orofacial herpes simplex virus infection in acute leukemia

Orofacial mucocutaneous infections resulting from herpes simplex virus (HSV) were detected in 40% of patients with acute leukemia. Of the 34 separate episodes, oral mucosal sites were involved in 22 cases. Evidence to support dissemination of HSV was found in 3 patients on 4 separate occasions. The relationship of neutrophil levels to the onset and resolution of lesions is examined. The value of acyclovir for treatment of these HSV-induced lesions is reported, and the question of administering this agent for routine prophylaxis against HSV in these patients is addressed.

Herpes simplex Virus Adsorption to and Survival within Placental Lymphoid Populations

Neonatal herpes simplex virus (HSV) infections are frequently characterized by widespread dissemination and high morbidity and mortality. To assess the potential role of the lymphocyte in permitting or promoting dissemination of HSV, we studied lymphoid populations of placental and adult blood with respect to HSV survival. Adsorption of HSV to the lymphocyte surface did not differ between placental and adult cells. Placental blood permitted greater survival of HSV than adult lymphocytes. T-cell-enriched lymphocytes appeared to be slightly more permissive than T-cell-depleted lymphocytes, but these differences were not statistically significant and apparently less than adult-placental blood differences. These findings lend support to the hypothesis that intracellular changes common to various neonatal lymphoid populations may permit or promote dissemination of HSV in the neonate.

Dissemination of herpes simplex virus in nude mice after intracutaneous inoculation and effect of antibody on the course of infection.

Dissemination of herpes simplex virus (HSV) in nude mice after intracutaneous inoculation in the midflank, and the effect of passively administered antibody on the course of infection were investigated. In untreated infected mice the skin lesions developed rapidly and HSV could first be recovered from the homogenate of the dorsal root ganglia on day 3 after infection, from the spinal cord on day 7 and from the brain on day 11. HSV could not be recovered from the blood, spleen or liver. In mice passively immunized with human gamma globulin, development of the skin lesions was rather slow and HSV could not be recovered from the homogenate of the dorsal root ganglia until day 16. From the results of explant culture of the ganglia, HSV was found to have reached the ganglia as early as 48 h after infection, even in mice administered human gamma globulin. The protective action of antibody seems to originate from the inhibition of virus growth not only at the inoculation site but also in the dorsal root ganglia.

Growth of Type 2 Herpes Simplex Virus in Newborn and Adult Mononuclear Leukocytes

Growth of type 2 herpes simplex virus (HSV) in newborn and adult human mononuclear leukocytes (MNL) was compared. Phytohemagglutinin stimulation of cultures for 3 days yielded comparable peak titers in newborn (10(5.3) PFU) and adult (10(5.1) PFU) MNL. Unexpectedly, 3-day cultures of unstimulated newborn MNL also substantially replicated HSV (10(4.7) PFU), whereas similarly treated unstimulated adult cells did not. Growth of HSV in freshly isolated human MNL was next investigated. MNL from 4 mothers and 6 nonpregnant adults showed no evidence of virus growth; however, leukocytes from 11 of 24 newborns (46%) supported replication. Newborn MNL manifested an increased ability to replicate HSV within 1 day of culture, whereas comparable growth in adult MNL was not achieved until the 4th day of culture. The significance of the above observations as it relates to visceral dissemination of HSV in the neonate is discussed.

Cutaneous dissemination of herpes simplex virus in individuals fifteen years of age and older

Cutaneous dissemination of herpes simplex virus in individuals fifteen years of age and older

Cutaneous dissemination of herpes simplex virus in individuals fifteen years of age and older

We have reported the case histories of two individuals with underlying atopic dermatitis who developed extensive vesicular eruptions. In both cases herpes simplex virus type l was isolated from skin lesions and both individuals ultimately recovered. These two cases represent only the third and fourth instances of this syndrome proven to be caused by herpes simplex virus type l that have been reported in older individuals. In addition we have reviewed the literature relative to cutaneous disseminated herpes simplex virus infections occurring in individuals over the age of 15 and have presented a comprehensive overview of this disease.

Antibody-dependent cellular protection against herpes simplex virus dissemination as revealed by viral plauqe and infectivity assays

Mouse nonimmune peripheral blood lymphocytes (PBL) plus antibody to herpes simplex virus inhibited virus dissemination in herpes simplex virus-infected 3T3 cell culture as revealed by development of viral plaque, size of immunofluorescent foci, appearance of polycaryocytes, and viral infectivity appearing in the culture. These nonimmune PBL did not act alone in inibiting virus dissemination, but did act synergistically in combination with antibody. The ratio of PBL to target monolayer cells needed to produce this effect was 20. Splenic lymphocytes had weak activity, whereas thymocytes were without effect, even in the presence of antibody. Neither interferon nor lymphotoxin was detected in this lymphocyte-mediated response. These findings support previous observations, based on cytotoxicity assays, that antibody-dependent cellular immune processes could be important in control of and recovery from herpesvirus infection.