表现为口咽肿块的单纯疱疹病毒

IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY
Evgeniya Molotkova BS, Anna C. Buhle BS, Patrick S. Rush DO, James E. McLean MD, Patrick S. Carpenter MD
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引用次数: 0

摘要

本文章由计算机程序翻译,如有差异,请以英文原文为准。

Herpes simplex virus presenting as an oropharyngeal mass

Herpes simplex virus presenting as an oropharyngeal mass

Objective(s)

Present a clinically challenging case of an immunocompetent 74-year-old male who presented with marked dyspnea and hemoptysis. After the airway was secured, direct laryngoscopy revealed a large, fungating, hemorrhagic mass of the left lateral pharyngeal wall and surrounding structures.

Methods

Chart review of a single patient. This patient provided consent for his case materials and images to be used for educational purposes and publication.

Results

The clinical appearance of the mass was suspicious for an aggressive neoplasm. Initial biopsy of the mass was nonspecific, revealing necrosis and inflammation, but was negative for malignancy. Due to concern for bacterial supraglottitis, empiric treatment with antibiotics was initiated. Cultures were positive for Fusobacterium necrophorum. Repeat biopsy samples showed signs of underlying human simplex virus (HSV) infection, which was confirmed with polymerase chain reaction (PCR) testing. After addition of acyclovir, the patient began to improve clinically and was eventually decannulated. There was complete resolution of the mass at his 1-month follow-up.

Conclusion

HSV supraglottitis is a rare, rapidly progressive, and highly morbid condition. Lack of overt patient risk factors, frequently inconclusive biopsies, and clinical appearance mimicking other etiologies make diagnosis challenging. Superimposed bacterial infection is even less common and may contribute to increased disease severity and progression.

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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
245
审稿时长
11 weeks
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