Clinical presentation of herpes simplex virus infection mimicking neoplasia on the face of persons living with HIV

The clinical presentations of herpes simplex virus (HSV) infections are varied and range from asymptomatic to a prodrome of tingling and burning followed by painful vesicles, erosions and ulcers. Resolution leads to latent infection of the sensory ganglia. HSV-1 is associated with most of the nongenital HSV–induced infections and HSV-2 is generally associated with anogenital lesions; however, lesions at either site may be caused by both viruses. In persons living with HIV (PLHIV), the lesions have been described as verrucous/hypertrophic, exophytic or vegetative and may suggest a neoplastic rather than an infective process and this can be a diagnostic dilemma in resource-limited countries with no access to confirmatory diagnostic testing for HSV. We report on two PLHIV who developed rapidly growing lesions on the face that clinically mimicked neoplasia but were found to be HSV-associated squamous proliferative lesions which responded to high dose acyclovir.

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Laboratory Diagnosis of Neonatal Herpes Simplex Virus Infections

Journal of Clinical Microbiology ◽

10.1128/jcm.01460-18 ◽

2019 ◽

Vol 57 (5) ◽

Cited By ~ 5

Author(s):

William J. Muller ◽

Xiaotian Zheng

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Diagnostic Testing ◽

Laboratory Diagnosis ◽

Clinical Findings ◽

Molecular Testing ◽

Virus Infections ◽

Neonatal Herpes ◽

Neonatal Herpes Simplex ◽

Simplex Virus

ABSTRACT Herpes simplex virus (HSV) is a common and often benign infection in humans; although it less commonly affects newborns, infection in this age group can be devastating. Newborns often present with nonspecific clinical findings, making timely and accurate diagnosis of infection critical. A wide variety of tests are available for detecting herpes simplex virus infection, but only a subset are useful and validated in the newborn population. The current review summarizes available diagnostic testing for neonatal disease, including discussing limitations, unmet needs, and emerging data on molecular testing methods.

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Herpes simplex virus encephalitis in a patient receiving ustekinumab associated with extensive cerebral oedema and brainshift successfully treated by immunosuppression with dexamethasone

BMJ Case Reports ◽

10.1136/bcr-2019-229468 ◽

2019 ◽

Vol 12 (8) ◽

pp. e229468 ◽

Cited By ~ 2

Author(s):

Harriet Kay Van Den Tooren ◽

Viraj Bharambe ◽

Nicholas Silver ◽

Benedict D Michael

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Cerebral Oedema ◽

Signalling Pathways ◽

High Dose ◽

Herpes Simplex Virus Encephalitis ◽

Midline Shift ◽

Csf Pleocytosis ◽

Atypical Presentations ◽

Simplex Virus

Herpes simplex virus (HSV) encephalitis affects 2–4 people per million/year. Immunocompomised patients can have atypical presentations of HSV encephalitis, including a lack of cerebrospinal fluid (CSF) pleocytosis. We present the case of a patient who was receiving ustekinumab therapy for psoriasis which inhibits interleukin (IL)-12 and IL-23 signalling pathways. The initial presentation was suggestive of encephalitis, but he was discharged prior to the reporting of HSV positivity due to the lack of CSF pleocytosis. On representation, he had worsening symptoms and imaging showed midline shift, indicating cerebral oedema despite the immunosupressant effects of ustekinumab. He required intensive care unit support and treatment with high dose aciclovir and dexamethasone; after a month of treatment he made a good recovery. This case is the first to report a link between ustekinumab and HSV encephalitis, and also emphasises that imunocompromised patients can lack CSF pleocytosis and develop significant cerebral oedema which responds to immune suppression.

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Treatment of Acyclovir-Resistant Herpes Simplex Virus with Continuous Infusion of High-Dose Acyclovir in Hematopoietic Cell Transplant Patients

Biology of Blood and Marrow Transplantation ◽

10.1016/j.bbmt.2010.06.020 ◽

2011 ◽

Vol 17 (2) ◽

pp. 259-264 ◽

Cited By ~ 20

Author(s):

Janet H. Kim ◽

Joanna M. Schaenman ◽

Dora Y. Ho ◽

Janice M.Y. Brown

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Continuous Infusion ◽

Hematopoietic Cell ◽

High Dose ◽

Cell Transplant ◽

Hematopoietic Cell Transplant ◽

Transplant Patients ◽

Simplex Virus

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High-dose acyclovir combined with foscavir (foscarnet) in the management of severe herpes simplex virus meningoencephalitis

Revue Neurologique ◽

10.1016/j.neurol.2017.03.006 ◽

2017 ◽

Vol 173 (4) ◽

pp. 240-242

Author(s):

S. Sagnier ◽

M. Poli ◽

S. Debruxelles ◽

P. Renou ◽

F. Rouanet ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

High Dose ◽

Simplex Virus

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Zinc Acetate/Carrageenan Gels Exhibit Potent ActivityIn Vivoagainst High-Dose Herpes Simplex Virus 2 Vaginal and Rectal Challenge

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.05461-11 ◽

2011 ◽

Vol 56 (1) ◽

pp. 358-368 ◽

Cited By ~ 50

Author(s):

José A. Fernández-Romero ◽

Ciby J. Abraham ◽

Aixa Rodriguez ◽

Larisa Kizima ◽

Ninochka Jean-Pierre ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Zinc Acetate ◽

Sexual Transmission ◽

High Dose ◽

Acetate Solution ◽

Sexual Transmission Of Hiv ◽

Simplex Virus ◽

Herpes Simplex Virus 2

ABSTRACTTopical microbicides that block the sexual transmission of HIV and herpes simplex virus 2 (HSV-2) are desperately needed to reduce the incidence of HIV infections worldwide. Previously we completed phase 3 testing of the carrageenan-based gel Carraguard. Although the trial did not show that Carraguard is effective in preventing HIV transmission during vaginal sex, it did show that Carraguard is safe when used weekly for up to 2 years. Moreover, Carraguard hasin vitroactivity against human papillomavirus (HPV) and HSV-2 and favorable physical and rheological properties, which makes it a useful vehicle to deliver antiviral agents such as zinc acetate. To that end, we previously reported that a prototype zinc acetate carrageenan gel protects macaques against vaginal challenge with combined simian-human immunodeficiency virus reverse transcriptase (SHIV-RT). Herein, we report the safety and efficacy of a series of zinc acetate and/or carrageenan gels. The gels protected mice (75 to 85% survival;P< 0.001) against high-dose (106-PFU) HSV-2 vaginal or rectal challenge. In contrast, zinc acetate formulated in HEC (hydroxyethylcellulose; or the Universal Placebo) failed to protect mice against the high-dose vaginal HSV-2 challenge (similar to aqueous zinc acetate solution and the placebo controls). The gels were found to be effective spreading gels, exhibited limited toxicityin vitro, caused minimal damage to the architecture of the cervicovaginal and rectal mucosaein vivo, and induced no increased susceptibility to HSV-2 infection in a mouse model. Our results provide a strong rationale to further optimize and evaluate the zinc acetate/carrageenan gels for their ability to block the sexual transmission of HIV and HSV-2.

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