Herpes Simplex Virus Pnueumonitis Associated with Oral-Labial Lesion and Tracheobronchitis in an Immunocompetent Patient with Acute Respiratory Distress Syndrome － A Case Report

Herpes simplex virus bronchopneumonia may be associated with acute respiratory distress syndrome (ARDS) in immunocompromised patients. However, herpes simplex virus-1 (HSV-1) detected in the lower respiratory tract in an immunocompetent patient may be pathogenic or colonization. We report the case of an immunocompetent female with pneumonia that progressed to ARDS. The diagnosis was supported by the presence of oral labial vesicles lesions and herpetic ulcers on the left main trachea. Both bronchoalveolar fluid and throat swab viral cultures yielded HSV-1. The pneumonic patches resolved to a great extent following antiviral therapy. Therefore, in patients with an unclear cause of pneumonia and acute hypoxemic respiratory failure, HSV-1 infection should be considered when findings include oral labial vesicles lesions, detection of herpes simplex virus in the throat, and endoscopic bronchial lesions.

關鍵字

herpes simplex virus type 1 ； oral-labial vesicles lesion ； acute respiratory distress syndrome

並列摘要

單純皰疹病毒肺炎引起急性呼吸窘迫症常見於免疫力不全病人。然而單純皰疹病毒在免疫力健全病人的臨床角色仍有爭議。本病人為無慢性疾病的中年婦女，本次住院主因為肺炎合併急性呼吸窘迫症。除了支氣管肺泡沖洗液培養病出單純皰疹病毒，並無任何致病菌可解釋其肺炎。病患的嘴巴口唇黏膜出現皰疹性潰瘍，並且在左主支氣管及左上肺葉支氣管都可在支氣管鏡檢查中看見皰疹性潰瘍病灶。經過抗病毒藥物治療後，病人肺部浸潤及氧合能力顯著改善。因脫離呼吸器困難，本病人最後仍死於菌血症合併敗血性休克。單純皰疹性病毒在免疫力健全病人身上仍可能引起肺炎及呼吸衰竭，早期發現並分析危險因子，將有助於臨床醫生正確診斷及治療。

並列關鍵字

單純皰疹性病毒；口腔黏膜皰疹性潰瘍；急性呼吸窘迫症

國際替代計量

Herpes Simplex Virus Pnueumonitis Associated with Oral-Labial Lesion and Tracheobronchitis in an Immunocompetent Patient with Acute Respiratory Distress Syndrome － A Case Report

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