title: A rare case of herpes simplex type 1 bronchopneumonia associated with cardiomegaly in renal transplantation.
abstract: BACKGROUND
  We report a rare case of herpes simplex virus (HSV) type 1B in patient with kidney transplant as a possible cause of patient death.
  
  
  METHODS
  A 32-year-old renal transplanted Caucasian man was referred for asthenia, fever, anemia, chest pain, cough, dyspnea, myalgias, peripheral edema, acute renal failure, diffuse cutaneus and mucous vesicles, and acute weight gain. The home therapy consisted of tacrolimus, sodic mycophenolate, and steroids. Laboratory data, bronchoscopy, and bronchial mucosal biopsy revealed HSV1B. We administered antiviral and antibiotic agents and reduced tacrolimus with clinical resolution. But after 10 days from discharge, the patient was admitted for acute cardiomegaly. So using ex adiuvantibus criteria we administered antiviral therapy with complete clinical improvement.
  
  
  CONCLUSIONS
  According to the literature, posttransplant HSV1B infection is a rare but severe complication of kidney transplantation associated with poor graft survival and a high mortality. Only an early, accurate diagnosis with efficient treatment permitted resolution of the problem. Our report stresses the difficulty of HSV2B clinical diagnosis and treatment.
authors.affiliation: Kidney Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy. vinicio1979@interfree.it
authors.forename: V
authors.initials: V
authors.lastname: Rizza
authors.forename: G
authors.initials: G
authors.lastname: Coletti
authors.forename: A
authors.initials: A
authors.lastname: Grimaldi
authors.forename: K
authors.initials: K
authors.lastname: Clemente
authors.forename: P
authors.initials: P
authors.lastname: Di Cocco
authors.forename: M
authors.initials: M
authors.lastname: D'Angelo
authors.forename: F
authors.initials: F
authors.lastname: Delreno
authors.forename: A
authors.initials: A
authors.lastname: Famulari
authors.forename: F
authors.initials: F
authors.lastname: Pisani
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D001996:Bronchopneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D001999:Bronchoscopy; D006332:Cardiomegaly / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D006561:Herpes Simplex / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D007166:Immunosuppressive Agents