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Updated: Oct 5, 2025

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Viral Ventilator-Associated Pneumonia/Hospital-Acquired Pneumonia
Charles-Edouard Luyt1,2, Guillaume Hékimian1,2, Nicolas Bréchot1,2
1Service de Médecine Intensive Réanimation, Sorbonne Université, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris.
Herpes simplex virus (HSV) reactivation is common in ICU patients and can cause pneumonia. While HSV bronchopneumonitis treatment may be advised, prophylactic antiviral therapy for HSV is not recommended.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Virology
Background:
- Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant concerns in healthcare settings.
- Herpes simplex virus (HSV) reactivation is frequently observed in intensive care unit (ICU) patients.
- Lung parenchymal involvement by HSV, termed HSV bronchopneumonitis, is a recognized complication.
Purpose of the Study:
- To review the role of viral infections, particularly HSV and cytomegalovirus (CMV), in healthcare-associated pneumonia (HAP) and ventilator-associated pneumonia (VAP).
- To discuss diagnostic approaches and treatment considerations for viral pneumonia in critically ill patients.
Main Methods:
- Review of existing literature on viral involvement in pneumonia, focusing on HSV and CMV.
- Analysis of diagnostic methods for HSV bronchopneumonitis, including cytological examination and viral load quantification in bronchoalveolar lavage samples.
- Evaluation of current recommendations regarding antiviral treatment for viral pneumonia in ICU settings.
Main Results:
- HSV reactivation is common in ICU patients, with HSV bronchopneumonitis being a well-described entity.
- Expert opinion suggests treating established HSV bronchopneumonitis but avoiding prophylactic or preemptive treatment for HSV reactivation.
- Cytomegalovirus (CMV) pneumonia is less common than HSV bronchopneumonitis and presents diagnostic challenges; data on antiviral treatment efficacy is lacking.
- The role of other respiratory viruses in VAP remains unclear.
Conclusions:
- HSV is a significant viral pathogen in ICU-acquired pneumonia, with specific diagnostic and treatment considerations.
- Prophylactic antiviral therapy for HSV reactivation in ICU patients is not supported.
- Further research is needed to clarify the role of CMV and other respiratory viruses in VAP and to establish optimal treatment strategies.
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