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Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern.
U Umans1, R P Golding, S Duraku
1Department of Radiology, Academic Hospital Vrije Universiteit, P.O. Box 7057, 1007MB Amsterdam, The Netherlands. umans@azvu.nl
European Radiology
|June 23, 2001
Summary
Herpes simplex virus pneumonia (HSVP) in 14 patients showed bilateral lung opacities on chest X-rays, often with airspace consolidation. Radiologists can suspect HSVP with these findings, especially when ARDS is unlikely.
Area of Science:
- Radiology
- Infectious Diseases
- Pulmonology
Background:
- Herpes simplex virus pneumonia (HSVP) is a rare but serious infection.
- Diagnosis is confirmed via viral isolation from broncho-alveolar lavage.
- Plain chest radiographs are crucial for initial assessment.
Observation:
- 17 patients with HSVP were retrospectively identified.
- 14 patients underwent chest radiography within 24 hours of bronchoscopy.
- 12 of 14 radiographs revealed bilateral lung opacities, predominantly lobar or more extensive.
Findings:
- Most patients presented with mixed airspace and interstitial patterns.
- 11 of 14 patients showed airspace consolidation.
- Atelectasis was seen in 7 patients, and pleural effusion in 8.
- Contrary to literature, most patients did not meet ARDS criteria.
Implications:
- Radiographic findings of bilateral airspace consolidation or mixed opacities may suggest HSVP in susceptible patients.
- HSVP should be considered even when ARDS or pulmonary edema are not suspected.
- Definitive diagnosis requires viral culture from broncho-alveolar lavage.