Fatal disseminated herpesvirus hominis type 2 infection in an adult with associated thymic dysplasia

• Published in: The American journal of medicine Vol. 56; no. 4; pp. 545 - 553
• Main Authors: Sutton, Albert L., Smithwick, Elizabeth M., Seligman, Stephen J., Kim, Dong-Sung
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.1974
• Subjects: Adult; Autopsy; Central Nervous System - pathology; Cervix Uteri - pathology; Female; Herpesviridae Infections - complications; Herpesviridae Infections - diagnosis; Herpesviridae Infections - immunology; Herpesviridae Infections - pathology; Humans; Immunologic Deficiency Syndromes - complications; Liver - pathology; Lymphatic System - pathology; Lymphoid Tissue - abnormalities; Simplexvirus; Spleen - pathology; Thymus Gland - abnormalities; Thymus Gland - pathology
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/0002-9343(74)90487-2

Disseminated herpesvirus hominis (HVH) type 2 infection, proved by viral isolation, is described in a previously healthy young woman. The clinical course was characterized by rapidly progressive hepatic failure leading to death 1 week after hospitalization. Postmortem examination showed involvement of many organs by HVH, most severe in the liver. The thymus gland showed dysplasia. It is suggested that this thymic alteration was congenital and was associated with a partial deficiency in cellular immunity, which permitted the patient's relatively long survival but ultimately rendered her susceptible to overwhelming viremia. Six adults with disseminated HVH infection, type unspecified but proved by viral isolation, were found in a review of the literature; predisposing factors (steroids, burns, Hodgkin's disease, malnutrition) existed in five patients. The thymus gland was not described, however, in the autopsy reports on any of the five patients who died. It is concluded that in order to initiate early antiviral therapy, HVH should be a diagnostic consideration in adults with hepatitis, particularly if skin or mucosal lesions are present. Furthermore, the central and peripheral lymphoid system of any patient who dies of a disseminated viral infection should be thoroughly examined.