Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus

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 s...

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Autores principales: Lee, Yu-Mi, Kim, So-Woon, Kwack, Won-Gun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624308/
https://www.ncbi.nlm.nih.gov/pubmed/34833380
http://dx.doi.org/10.3390/medicina57111162
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author Lee, Yu-Mi
Kim, So-Woon
Kwack, Won-Gun
author_facet Lee, Yu-Mi
Kim, So-Woon
Kwack, Won-Gun
author_sort Lee, Yu-Mi
collection PubMed
description 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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spelling pubmed-86243082021-11-27 Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus Lee, Yu-Mi Kim, So-Woon Kwack, Won-Gun Medicina (Kaunas) Case Report 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. MDPI 2021-10-26 /pmc/articles/PMC8624308/ /pubmed/34833380 http://dx.doi.org/10.3390/medicina57111162 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Lee, Yu-Mi
Kim, So-Woon
Kwack, Won-Gun
Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus
title Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus
title_full Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus
title_fullStr Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus
title_full_unstemmed Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus
title_short Tracheitis Caused by Coinfection with Cytomegalovirus and Herpes Simplex Virus
title_sort tracheitis caused by coinfection with cytomegalovirus and herpes simplex virus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624308/
https://www.ncbi.nlm.nih.gov/pubmed/34833380
http://dx.doi.org/10.3390/medicina57111162
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