Pneumonia failing to respond to treatment

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• 作者：Michael Pallin ; Caroline O'Connell ; Annemarie Mclaughlin ; Brendan Crowley ; Rory O'Donnell
• 关键词：Herpes simplex virus type 1 ; Pneumonia ; Quantitative PCR ; Corticosteroids ; Immunocompromise
• 刊名：Respiratory Medicine CME
• 出版年：2009
• 出版时间：2009
• 年：2009
• 卷：2
• 期：2
• 页码：99-101
• 全文大小：346 K

文摘

Summary

Herpes simplex virus type 1 (HSV-1) is frequently isolated from the respiratory tract of critically ill patients. However, diagnosis of clinically significant HSV-1 pneumonia is difficult as the presentation is non-specific and there is no diagnostic reference standard to differentiate from non-infectious contamination.

We present a case of HSV-1 pneumonia in a young asthmatic patient who was potentially immunocompromised through long-term corticosteroid usage. The quantitative PCR titre from bronchoalveolar lavage fluid was high (9 × 10³ copies/ml) and the patient made a dramatic clinical and radiographic recovery upon treatment with acyclovir. We suggest that similar PCR levels in the appropriate clinical setting should prompt consideration of anti-viral therapy.