Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Oct 25:17:4649-4653.
doi: 10.2147/IDR.S482829. eCollection 2024.

Diagnostic Dilemma of Herpes Simplex Virus Type 1 Pneumonia or Colonization: A Case Report

Jia-Jie Zhong  1 , Chia-Hung Tsai  2 , Wen-Ying Lee  3
Affiliations
Case Reports

Diagnostic Dilemma of Herpes Simplex Virus Type 1 Pneumonia or Colonization: A Case Report

Jia-Jie Zhong et al. Infect Drug Resist. .

Abstract

Herpes simplex virus type 1 (HSV1) pneumonia presents diagnostic challenges due to there being no gold-standard criteria currently. Specimens from bronchoalveolar lavage can increase specificity, and cytohistological examination can prove virus infection. Patients with high viral load have been reported with poor outcomes and benefited from antiviral agent. We describe an 80-year-old man with severe pneumonia who initially showed improvement without antiviral therapy, despite viral inclusion bodies on sputum cytology and positive HSV1 polymerase chain reaction from sputum, though subsequent clinical deterioration due to Pseudomonas aeruginosa infection necessitated intensive care. This case highlights the complexities of diagnosing and managing HSV1 pneumonia, emphasizing the importance of integrating clinical suspicion, radiological imaging, and laboratory tests for timely therapeutic decisions in critically ill patients.

Keywords: antiviral therapy; herpes simplex virus type 1; pneumonia; polymerase chain reaction; sputum cytology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Pneumonia patches on chest CT.
Figure 2
Figure 2
Multinucleated cells with ground-glass appearance on sputum cytology.
Figure 3
Figure 3
Regression of pneumonia on chest X-ray: A day 1, B day 7, C day 12.
Figure 4
Figure 4
Timeline of clinical course.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Conway Morris A, Smielewska A. Viral infections in critical care: a narrative review. Anaesthesia. 2023;78(5):626–635. doi:10.1111/anae.15946 - DOI - PMC - PubMed
    1. Pata R, Datar P. The Diagnosis and Management of Herpes Simplex Pneumonia in the Critical Care Setting: a Comprehensive Review. Cureus. 2023;15(8):e43224. doi:10.7759/cureus.43224 - DOI - PMC - PubMed
    1. Huang L, Zhang X, Pang L, et al. Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study. J Med Virol. 2023;95(1):e28337. doi:10.1002/jmv.28337 - DOI - PMC - PubMed
    1. Xu J, Zhong L, Shao H, et al. Incidence and clinical features of HHV-7 detection in lower respiratory tract in patients with severe pneumonia: a multicenter, retrospective study. Crit Care. 2023;27(1):248. doi:10.1186/s13054-023-04530-6 - DOI - PMC - PubMed
    1. Jiang Y, Huang X, Zhou H, et al. Clinical Characteristics and Prognosis of Patients With Severe Pneumonia With Pneumocystis jirovecii Colonization: a Multicenter, Retrospective Study. Chest. 2024. doi:10.1016/j.chest.2024.07.140 - DOI - PubMed

Publication types

Grants and funding

There is no funding to report.

LinkOut - more resources