Fatal pulmonary disease and encephalic complication in a man with HSV-1 Infection: a case report

Herpes simplex virus type 1 (HSV-1) is associated with a large spectrum of pathologies i.e. pulmonary diseases. Although it has often been isolated from the lower respiratory tract of immunocompetent or immunosuppressed patients undergoing prolonged mechanical ventilation (MV), its causative role in serious lung infections is still unclear. Here we report the case of a 44-year-old man presenting seizures that followed an acute respiratory illness that occurred during hospitalization. The detection of HSV-1 DNA in bronchoalveolar lavage (BAL), in spinal fluid, and in blood samples, supported the evidence of a disseminated viral infection that strengthens the hypothesis of herpetic pneumonia as a possible triggering cause of neurological complications and fatal outcome. This observation draws attention to the opportunity of introducing tests for the detection of HSV-1 into the diagnostic protocols for such patients. In fact, adequate diagnostic tools would favor early diagnosis and correct therapy to HSV-1 that could reduce the possibility of either encephalic complications or the rate of mortality in critical long-term patients affected by respiratory pathologies who need assisted ventilation.