Endobronchial Pseudo-tumor caused by herpes simplex

Zainulabid, Ummu Afeera and Abdul Razak, Megat Razeem and How, Soon Hin and Ibrahim, Aishah and Abdullah, Suhaila and Syed Yasin, Sharifah Nor Ashikin (2019) Endobronchial Pseudo-tumor caused by herpes simplex. In: Malaysian Thoracic Society Congress 2019, 18th- 21st July 2019, The Royale Chulan Hotel, Kuala Lumpur Malaysia. (Unpublished)

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Abstract

Introduction Endobronchial Pseudo-tumor like lesions has been described very rarely as HSV pulmonary manifestations in critically ill patients or in immunosuppressed individuals. Methodology - Case Report 64 year old Malay male with background history of DM and hypertension with good premorbid condition presented with a short duration of fever, cough and SOB (3 days). This patient was initially treated as CAP with ARDS, complicated with recurrent nosocomial infection. Serial CXR showed persistent right upper lobe lung collapse. CECT Thorax showed air space opacities with air-bronchograms seen at posterior segment of right upper lobe associated with surrounding ground glass opacities. Multiple cystic lesions and dilated airways are seen at right upper lobe adjacent to and within the consolidation. During his ICU stay, anaesthesiology team had difficulty with weaning of oxygenation thus decided for bronchoscopy which revealed suspicious growth at middle lobe of the right lung. At D26 of ICU admission, case was referred to respiratory team. Repeated bronchoscopy was done and it showed nodular ‘warty’ appearance lesion at right bronchus intermedius. Endobronchial biopsy taken and the result is consistent with herpes infection as evident by balloon degeneration free lying epithelium with ground glass nuclei admixed with necrotic tissue with inflammatory exudate. Endobronchial tissue also shows intranuclear inclusion. Patient was started on IV Acyclovir. However, this patient succumbed later due to severe Klebsiella CRE nosocomial infection. Conclusion Diagnosis of HSV infection is feasible from the characteristic cytological and histological findings seen in samples obtained by bronchoscopic examination. The presence of intranuclear inclusions is considered to be useful cytopathic feature in diagnosing HSV.

Item Type:	Conference or Workshop Item (Poster)
Additional Information:	7459/88379
Uncontrolled Keywords:	Herpes Simplex Virus, Endobronchial Pseudo-tumor
Subjects:	R Medicine > RC Internal medicine > RC111 Infectious and Parasitic Diseases
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Internal Medicine Kulliyyah of Medicine
Depositing User:	Asst. Dr. Ummu Afeera Zainulabid
Date Deposited:	17 Feb 2021 11:26
Last Modified:	17 Feb 2021 11:26
URI:	http://irep.iium.edu.my/id/eprint/88379

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