Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus

被引:0
|
作者
Lee, Yu-Mi [1 ]
Kim, So-Woon [2 ]
Kwack, Won-Gun [3 ]
机构
[1] Kyung Hee Univ, Kyung Hee Univ Hosp, Div Infect Dis, Dept Internal Med,Sch Med, Seoul 02447, South Korea
[2] Kyung Hee Univ, Kyung Hee Univ Hosp, Dept Pathol, Sch Med, Seoul 02447, South Korea
[3] Kyung Hee Univ Hosp, Div Pulm Allergy & Crit Care Med, Dept Internal Med, Seoul 02447, South Korea
来源
MEDICINA-LITHUANIA | 2021年 / 57卷 / 11期
关键词
cytomegalovirus; herpes simplex virus; tracheitis; INFECTION; PATIENT;
D O I
10.3390/medicina57111162
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Clinically significant isolated viral tracheitis is scarce in adults, and upper airway obstruction caused by viral tracheitis is even more infrequent. A 74-year-old woman, who was administered low-dose steroids for two months for chronic obstructive pulmonary disease (COPD), developed dyspnea with stridor and required mechanical ventilation for respiratory failure. Chest computed tomography showed a diffuse tracheal wall thickening with luminal narrowing and peribronchial consolidation in the right upper lobe. Bronchoscopy revealed a proximal tracheal narrowing with multiple ulcerations of the tracheal mucosa surrounded by an erythematous margin. Pathologic examinations of the tracheal mucosal tissue, including immunohistochemistry, revealed a cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Furthermore, the bronchial alveolar lavage fluid was positive on the CMV real-time polymerase chain reaction. The patient was treated with intravenous ganciclovir for 44 days. The follow-up bronchoscopy 49 days after the initiation of ganciclovir revealed improved multiple ulcerations with scars. We report a rare case of tracheitis caused by coinfection with CMV and HSV in a patient with COPD who had been taking low-dose steroids for months. The case showed that CMV and HSV are potential causes of serious tracheitis and respiratory failure.
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