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Hemophagocytic syndrome caused by primary herpes simplex virus 1 infection: report of a first case

Cusini, A. ; Günthard, H. ; Stussi, G. ; Schwarz, U. ; Fehr, T. ; Grueter, E. ; Meerbach, A. ; Bossart, W. ; Schaer, D. ; Rudiger, A.

In: Infection, 2010, vol. 38, no. 5, p. 423-426

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    Titre
    • Hemophagocytic syndrome caused by primary herpes simplex virus 1 infection: report of a first case
    Auteur
    • Cusini, A.. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091, Zurich, Switzerland
    • Günthard, H.. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091, Zurich, Switzerland
    • Stussi, G.. Division of Haematology, University Hospital Zurich, Zurich, Switzerland
    • Schwarz, U.. Division of Neurology, University Hospital Zurich, Zurich, Switzerland
    • Fehr, T.. Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
    • Grueter, E.. Division of Nephrology, Cantonal Hospital Baden, Baden, Switzerland
    • Meerbach, A.. Institute of Medical Virology, University of Zurich, Zurich, Switzerland
    • Bossart, W.. Institute of Medical Virology, University of Zurich, Zurich, Switzerland
    • Schaer, D.. Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
    • Rudiger, A.. Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:309738
    Summary
    Introduction: Hemophagocytic syndrome represents a severe hyperinflammatory condition by activated macrophages. Leading viral triggering agents are Epstein-Barr virus (EBV), cytomegalovirus (CMV), and adenovirus. Materials and methods: We present a patient with Wegener's granulomatosis on azathioprine and prednisone medication, who developed a life-threatening hemophagocytic syndrome. Positive plasma polymerase chain reaction (PCR) with negative serology revealed a primary, disseminated infection with herpes simplex virus-1 as the triggering pathogen. After treatment with acyclovir, high-dose steroids, immunoglobulins, and etoposide, the patient recovered. Conclusion: Early diagnosis of potentially underlying infections of hemophagocytic syndrome influences the therapeutic approach. It is important to consider a variety of infectious agents, particularly in immunosuppressed individuals. The reported case emphasizes the importance of screening for herpes simplex virus 1