Atypical Presentation of Herpes Simplex 1 Virus in a COVID-19 Patient

M. J. Guimarães, F. Azevedo, C. Lisboa
{"title":"Atypical Presentation of Herpes Simplex 1 Virus in a COVID-19 Patient","authors":"M. J. Guimarães, F. Azevedo, C. Lisboa","doi":"10.29021/spdv.79.4.1408","DOIUrl":null,"url":null,"abstract":"A 74-year-old man with past medical history of obesity and type 2 diabetes mellitus was admitted for COVID-19 pneumonia. Due to unfavorable disease progression, ten days later, the patient was admitted to the intensive care unit and intubated, requiring periods of prone position and systemic corticosteroid treatment. During the following weeks, the patient developed several infectious complications successfully managed with systemic antibiotics and herpes simplex infection of the left upper lip, treated with acyclovir 400 mg twice daily for 10 days. Dermatology observation was requested 2 days after acyclovir cessation due to an infiltrative hyperkeratotic erythematous plaque with pustules on the right zygomatic region (see picture 1) that had been noticed 2 days before. Polymerase chain reaction (PCR)-testing of swab samples from the pustules was positive for herpes simplex virus (HSV) 1, with negativity for HSV 2 and for varicella-zoster virus (VZV). Blood and CSF fluid PCR were negative for HSV 1, HSV 2 and VZV. The patient restarted acyclovir (400 mg, thrice daily for 12 days) with significant improvement of the lesion (less infiltration and hyperkeratotic crusts) and negative PCR-testing for HSV1 DNA after treatment cessation (see picture 2). About 2 weeks later the lesion was completely healed leaving a minor atrophic scar.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Portuguese Society of Dermatology and Venereology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29021/spdv.79.4.1408","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

A 74-year-old man with past medical history of obesity and type 2 diabetes mellitus was admitted for COVID-19 pneumonia. Due to unfavorable disease progression, ten days later, the patient was admitted to the intensive care unit and intubated, requiring periods of prone position and systemic corticosteroid treatment. During the following weeks, the patient developed several infectious complications successfully managed with systemic antibiotics and herpes simplex infection of the left upper lip, treated with acyclovir 400 mg twice daily for 10 days. Dermatology observation was requested 2 days after acyclovir cessation due to an infiltrative hyperkeratotic erythematous plaque with pustules on the right zygomatic region (see picture 1) that had been noticed 2 days before. Polymerase chain reaction (PCR)-testing of swab samples from the pustules was positive for herpes simplex virus (HSV) 1, with negativity for HSV 2 and for varicella-zoster virus (VZV). Blood and CSF fluid PCR were negative for HSV 1, HSV 2 and VZV. The patient restarted acyclovir (400 mg, thrice daily for 12 days) with significant improvement of the lesion (less infiltration and hyperkeratotic crusts) and negative PCR-testing for HSV1 DNA after treatment cessation (see picture 2). About 2 weeks later the lesion was completely healed leaving a minor atrophic scar.
1例COVID-19患者单纯疱疹1型病毒的不典型表现
74岁男性,既往有肥胖和2型糖尿病病史,因COVID-19肺炎入院。由于病情进展不利,10天后,患者住进重症监护室并插管,需要一段时间的俯卧位和全身皮质类固醇治疗。在接下来的几周内,患者出现了几种感染并发症,通过全身抗生素和左上唇的单纯疱疹感染成功地得到了控制,服用阿昔洛韦400mg,每天两次,持续10天。停用阿昔洛韦2天后,因2天前发现右侧颧区出现浸润性角化性红斑斑块伴脓疱(见图1),要求进行皮肤观察。聚合酶链反应(PCR)-从脓疱中提取的拭子样本检测为单纯疱疹病毒(HSV) 1阳性,HSV 2和水痘-带状疱疹病毒(VZV)阴性。血液和脑脊液PCR检测均为HSV 1、HSV 2和VZV阴性。患者重新使用阿昔洛韦(400mg,每日三次,连用12天),病变明显改善(浸润减少,角化结痂过度),停药后HSV1 DNA pcr检测呈阴性(见图2)。约2周后病变完全愈合,留下轻微萎缩性疤痕。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信