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A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation
Published on: April 2, 2012
Extensive perinephric abscess complicated by herpes simplex virus 1 reactivation
S A Alleyne1, S S Bukhari, M Fraser
1Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
Journal of Clinical Pathology
|April 1, 2010
Summary
A patient with deep vein thrombosis developed sepsis, a perinephric abscess, and herpes simplex virus reactivation. This case highlights treatment challenges with multiresistant bacteria and viral reactivation in critically ill patients.
Area of Science:
- Infectious Diseases
- Nephrology
- Critical Care Medicine
Background:
- Deep vein thrombosis (DVT) can lead to severe complications.
- Perinephric abscesses are rare but serious renal infections.
- Critically ill patients are susceptible to opportunistic infections and antimicrobial resistance.
Observation:
- A 43-year-old male with DVT presented with sepsis, right hydronephrosis, and a large retroperitoneal collection.
- Initial cultures revealed Escherichia coli resistant to amoxicillin.
- The patient later developed a vesicular rash, and herpes simplex virus 1 (HSV-1) was identified.
Findings:
- CT scans showed progression of the retroperitoneal collection and a new upper leg collection.
- Tissue cultures identified extended-spectrum beta-lactamase (ESBL) producing E. coli.
- HSV-1 was detected in tissue via PCR, indicating coinfection and reactivation.
Implications:
- This case underscores the potential for unusual presentations and complications of perinephric abscesses.
- Reactivation of herpes simplex virus and the emergence of multidrug-resistant organisms pose significant treatment challenges in immunocompromised and critically ill patients.
- Prompt recognition and management of coinfections are crucial for improving outcomes in severe sepsis.
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