Herpes simplex virus pneumonia in a patient with ependymoma.
The authors report a fatal outcome in a 4-year-old boy with herpes simplex virus (HSV) pneumonia and ependymoma. The patient had respiratory distress that worsened despite antibiotic treatment. Bronchoalveolar lavage showed intranuclear viral inclusions, and culture was positive for HSV type 1. His T-cell count was significantly decreased. Although acyclovir and foscarnet were given, the patient died. Postmortem examination showed HSV pneumonitis with severe alveolar damage and severe involutional changes of the thymus with absence of Hassall's corpuscles. HSV must be considered in the differential diagnosis of patients with interstitial pneumonia and T-cell deficiency, especially after craniospinal irradiation.
Inaba
Hiroto
H
Divisions of Pediatric Hematology/Oncology, Children's Hospital of Michigan, Detroit, Michigan 38105, USA. Hiroto.Inaba@stjude.org
Rabah
Raja
R
Meert
Kathleen L
KL
BhamBhani
Kanta
K
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology*; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004806:Ependymoma / Q000188:drug therapy / Q000473:pathology*; D017809:Fatal Outcome; D017245:Foscarnet / Q000627:therapeutic use; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D006801:Humans; D007111:Immunity, Cellular; D008297:Male; D009364:Neoplasm Recurrence, Local; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000188:drug therapy; D013601:T-Lymphocytes / Q000378:metabolism
D000998:Antiviral Agents; D017245:Foscarnet; D000212:Acyclovir