Herpes simplex virus bronchiolitis in a cannabis user

Area of Science:

• Infectious Diseases
• Pulmonology
• Virology

Background:

• Herpes simplex virus (HSV) typically causes orolabial or genital lesions.
• Lower respiratory tract infections (LRTI) due to HSV are rare in immunocompetent adults.
• Chronic habitual marijuana use is increasingly recognized for potential health impacts.

Purpose of the Study:

• To report an unusual case of HSV-induced bronchiolitis and pneumonitis.
• To explore the potential association between chronic marijuana use and HSV LRTI.
• To raise awareness of HSV as a differential diagnosis in specific patient populations.

Main Methods:

• Case report of an immunocompetent adult presenting with respiratory symptoms.
• Clinical evaluation including history of marijuana use and orolabial ulcer.
• Diagnostic workup to identify the causative pathogen.

Main Results:

• The patient presented with symptoms consistent with bronchiolitis and pneumonitis.
• Herpes simplex virus was identified as the causative agent of the lower respiratory tract infection.
• The infection was temporally associated with a concurrent orolabial herpetic outbreak and a history of chronic marijuana use.

Conclusions:

• Herpes simplex virus should be considered in the differential diagnosis of uncommon lower respiratory tract infections, particularly in individuals with risk factors.
• Chronic habitual marijuana use may be an underrecognized factor predisposing to HSV lower respiratory tract disease.
• This case underscores the importance of considering viral etiologies beyond typical bacterial pathogens in respiratory infections.