Herpes simplex viral pneumonia after coronary artery bypass grafting.
We report a case of herpes simplex viral (HSV) pneumonia as a post-CABG pulmonary complication in a 70-year-old man. Chest radiography on postoperative day 9, showed a glass-like shadow and pleural effusion in the left lung field, and the man's condition began deteriorating rapidly. Bronchofiberscopy to detect the pathogen and a bronchoalveolar lavage with polymerase chain reaction (PCR) yielded a definitive diagnosis of HSV pneumonia. Once therapy with acyclovir was begun, his condition improved markedly. Our case suggests that 1 viral pulmonary infection should be considered as a possible cause in postoperative cardiac patients with unexplained progressive pulmonary infiltrates, and 2 DNA amplification using PCR is rapid--it can be completed within 1 day--and sensitive and specific in diagnosing such infections.
Second Department of Surgery, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.
Ken-ichi
K
Arata
Ryuzo
R
Sakata
Yoshifumi
Y
Iguro
Riichiro
R
Toda
Shun-Ichi
S
Watanabe
Yoshito
Y
Eitsuru
D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D001026:Coronary Artery Bypass; D006561:Herpes Simplex / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000209:etiology*; D011183:Postoperative Complications
D000212:Acyclovir