1/70. Human herpes-virus 8 seropositive patient with skin and graft Kaposi's sarcoma after lung transplantation.Kaposi's sarcoma (KS) has been reported after solid organ transplantation mostly in recipients of renal, liver, heart, and bone allografts. We describe the first case of a patient with lung transplantation who developed KS of the skin, but also of the lung graft. The tumors were localized to places of previous trauma, implying the involvement of a Koebner phenomenon. Moreover, a polymerase chain reaction assay revealed the presence of dna sequences of herpesvirus 8 (HHV-8) on tissue of the cutaneous KS. Serological tests showed HHV-8 seronegativity of the graft donor and HHV-8 seropositivity of the patient before lung transplantation suggesting that the latter was already infected before the surgery and that immunosuppression resulted in the development of KS. This case report raises the question of the prevalence of HHV-8 in candidates for transplantation and organ donors, and of the value of an antiviral prophylaxis to lower the risk of KS.- - - - - - - - - - ranking = 1keywords = herpes (Clic here for more details about this article) |
2/70. adult herpetic laryngitis with concurrent candidal infection: a case report and literature review.Rarely, adult herpetic laryngitis without involvement of the oropharynx has been reported. However, to our knowledge, laryngitis caused by herpes simplex virus with coexisting candida albicans has not been reported. We report what we believe to be the first case of localized herpetic laryngitis superimposed by laryngeal Candida species infection in an immunosuppressed patient. This diagnosis was made on the basis of the findings of a laryngeal mucosal biopsy and ancillary testing using fungal stains and immunohistochemical stains for herpetic antigens. We also review the literature and discuss the clinical and diagnostic presentations, including potential pitfalls in the diagnosis.- - - - - - - - - - ranking = 2.3309373114282keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
3/70. stenotrophomonas maltophilia endophthalmitis after intraocular lens implantation.BACKGROUND: stenotrophomonas maltophilia is an opportunistic, gram-negative bacillus. endophthalmitis induced by S. maltophilia has been described in only two cases after intraocular lens implantation. We report S. maltophilia endophthalmitis in two patients with diabetes mellitus after intraocular lens implantation and compare the characteristics of the S. maltophilia-induced endophthalmitis with two previous cases. methods: A 68-year-old woman and a 74-year-old man with diabetes mellitus developed S. maltophilia endophthalmitis within 5 days of intraocular lens implantation. We performed intraocular lens removal and vitrectomy, which resolved the inflammation. No recurrences were found. RESULTS: Cultures grew S. maltophilia in both cases, and one of the organisms was multi-resistant. The final visual acuity was counting fingers and 0.3. The first case revealed a tractional retinal detachment during vitrectomy. CONCLUSIONS: S. maltophilia is a potential opportunistic intraocular pathogen, and the incidence of multiresistant S. maltophilia is increasing. S. maltophilia causes acute endophthalmitis, and its prognosis may not be poor unless the eye has a history of serious disease before the cataract surgery. The combined procedure of intraocular lens removal and vitrectomy was useful in resolving the inflammation and preventing recurrences.- - - - - - - - - - ranking = 0.013347101675866keywords = ocular (Clic here for more details about this article) |
4/70. Synchronous herpes simplex virus and cytomegalovirus esophagitis.Infective esophagitis is a rare disease, affecting mostly immunocompromised patients. Very few cases of a multiple viral infection have been reported. We present a case of combined cytomegalovirus (CMV) and herpes simplex virus (HSV) esophagitis in an 81-year-old female with extracapillary sclerosing glomerulonephritis treated for five months with steroids and chemotherapy. She died of septic shock. At autopsy, erosive and ulcerative esophagitis was found in the distal half of the esophagus. Slides were stained by HE, and the immunohistochemical avidin-biotin method was used to detect HSV and CMV infection. On histological examination of the esophagus, epithelial giant cells with intranuclear viral inclusions showing HSV immunopositivity were found at the margin of the ulcerations. giant cells with intranuclear inclusions with CMV immunopositivity were also found in the mesenchymal cells obtained from the ulcer bed. Long-term immunosuppressive therapy provoked an immune deficiency, evidenced by grave leukopenia and depletion of all bone marrow elements. diagnosis of HSV and CMV esophagitis is important to evaluate the risk of hemorrhage and esophageal perforation in esophagitis.- - - - - - - - - - ranking = 11.654686557141keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
5/70. A toddler with burns, stomatitis, and skin graft loss.The authors report on a healthy 21-month-old toddler with 13% TBSA deep scald burns who was successfully grafted (take 100%). In the immediate postoperative phase, the patient developed classical aphthous stomatitis and subsequent herpes viremia leading to severe viral "graftitis". Although immediately administered intravenous acyclovir therapy appeared to be effective, one third of grafts were lost and had to be replaced. The lesson from this case is 2-fold: Herpes infection may threaten even perfectly engrafted fresh skin transplants, and, freshly grafted or soon to be grafted burn patients should be given intravenous antiviral therapy as soon as a herpes infection is diagnosed.- - - - - - - - - - ranking = 0.4keywords = herpes (Clic here for more details about this article) |
6/70. Simultaneous multiorgan presence of human herpesvirus 8 and restricted lymphotropism of Epstein-Barr virus dna sequences in a human immunodeficiency virus-negative immunodeficient infant.Because a profound dysregulation of the immune system occurs in primary immunodeficiencies, viral infections are not uncommon. Human herpesvirus (HHV)-8 dna was detected by polymerase chain reaction (PCR) analysis, Southern blotting, and in situ hybridization (ISH) in peripheral blood mononuclear cells and lymphoid organs (bone marrow, spleen, and lymph nodes) and endothelial and epithelial cells and macrophages from several organs (skin, lung, esophagus, intestine, choroid plexus [but not in brain or cerebellum], heart, striated muscle, liver, and kidney) of a human immunodeficiency virus-negative infant with DiGeorge anomaly who died of disseminated infection. Epstein-Barr virus dna sequences were detected in the spleen and lymph nodes (by PCR and ISH) and in bone marrow (only by ISH) but not in blood or nonlymphoid organs. This report is believed to be the first of multiorgan dissemination of HHV-8 in a primary immunodeficiency.- - - - - - - - - - ranking = 1keywords = herpes (Clic here for more details about this article) |
7/70. herpes simplex virus 1 pneumonia: conventional chest radiograph pattern.The aim of this study was to describe the findings on plain chest radiographs in patients with herpes simplex virus pneumonia (HSVP). The study was based on 17 patients who at a retrospective search have been found to have a monoinfection with herpes simplex virus. The diagnosis was established by isolation of the virus from material obtained during fiberoptic bronchoscopy (FOB) which also included broncho-alveolar lavage and tissue sampling. Fourteen patients had a chest radiograph performed within 24 h of the date of the FOB. Two radiographs showed no abnormalities of the lung parenchyma. The radiographs of the other 12 patients showed lung opacification, predominantly lobar or more extensive and always bilateral. Most patients presented with a mixed airspace and interstitial pattern of opacities, but 11 of 14 showed at least an airspace consolidation. Lobar, segmental, or subsegmental atelectasis was present in 7 patients, and unilateral or bilateral pleural effusion in 8 patients, but only in 1 patient was it a large amount. In contradiction to the literature which reports a high correlation between HSVP and acute respiratory distress syndrome (ARDS), 11 of 14 patients did not meet the pathophysiological criteria for ARDS. The radiologist may suggest the diagnosis of HSVP when bilateral airspace consolidation or mixed opacities appear in a susceptible group of patients who are not thought to have ARDS or pulmonary edema. The definite diagnosis of HSV pneumonia can be established only on the basis of culture of material obtained by broncho-alveolar lavage.- - - - - - - - - - ranking = 5.9538998802184keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
8/70. Disseminated herpes simplex virus and varicella zoster virus coinfection in a patient taking thalidomide for relapsed multiple myeloma.Disseminated herpes simplex virus (HSV) and varicella zoster virus (VZV) have been reported individually in immunosuppressed adults. We present a case of coinfection with disseminated HSV and VZV infection in a patient taking thalidomide for relapsed multiple myeloma. This is the first report of opportunistic infection associated with thalidomide.- - - - - - - - - - ranking = 11.654686557141keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
9/70. Endogenous pneumococcal endophthalmitis followed by pneumococcal-induced uveitis.BACKGROUND: We describe the case of a fulminant bilateral endophthalmitis occurring in a patient, who had 9 years earlier a splenectomy for an idiopathic thrombocytopenic purpura. history AND SIGNS: A 40-year-old woman, back from a trip to morocco, presented with high fever, rapid decrease in visual acuity and loss of consciousness. Medical examination revealed a pneumococcal meningitis and bilateral endophthalmitis. THERAPY AND OUTCOME: endophthalmitis was treated with local and intravitreal antibiotics injections (vancomycin and amikacin). Repeated parabulbar betamethasone injections were performed. Intravenous (iv) methylprednisolone pulses were followed by oral steroid therapy while systemic antibiotics were given (ceftriaxone and vancomycin). In spite of this therapy, fundus examination was impossible because the anterior chamber was filled with fibrin. A cataract developed with severe vitritis and we could observe a progressive narrowing of the anterior chamber. The patient underwent a bilateral vitrectomy and lensectomy. The retina had no lesion. No bacteria were found in the vitreous culture. Evolution was characterized by an increased ocular pressure due to anterior synechiae. visual acuity remained under 1/10. The severe ocular inflammation could be the result of a mixed mechanism including an infectious followed by a severe immune response against bacterial components. CONCLUSIONS: This case report is rare. To our knowledge, only 3 similar cases have been reported in the literature.- - - - - - - - - - ranking = 0.0026694203351732keywords = ocular (Clic here for more details about this article) |
10/70. nursing care of patients with ocular manifestations of human immunodeficiency virus infection.With the rising incidence of AIDS in the united states, a larger number of patients with hiv-related infectious and noninfectious ocular conditions will inevitably occur. This necessitates that ophthalmic nurses have knowledge of hiv disease; resultant ophthalmic manifestations; treatment protocols, including unapproved therapies; community resources for persons with vision loss; social issues related to hiv; psychologic responses to the disease; and associated losses for patients and their families. This knowledge base will enable the nurse to recognize disease earlier, to educate patients and their families, to administer treatment, and to provide support to a population in critical need of nursing interventions.- - - - - - - - - - ranking = 0.0066735508379331keywords = ocular (Clic here for more details about this article) |
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