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Two Cases of Herpes Virus Infection of Nose Mimicking Acute Invasive Fungal Infection in Immunocompromised Hosts

Changhee Lee1, Yong Gi Jung1, Hyo-Yeol Kim1

  • 1Departments of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Journal of Rhinology : Official Journal of the Korean Rhinologic Society
|December 12, 2024
PubMed

Insights

Acute invasive fungal infections (AIFI) are fatal in immunocompromised patients. Nasal herpes simplex virus (HSV) infections can mimic AIFI, necessitating rapid differential diagnosis to guide appropriate treatment and improve outcomes.

Area of Science:

  • Infectious Diseases
  • Immunocompromised Hosts
  • Mycology
  • Virology

Background:

  • Acute invasive fungal infections (AIFI) pose a significant mortality risk in immunocompromised individuals.
  • Nasal herpes simplex virus (HSV) infections, particularly HSV-1, can present with symptoms mimicking AIFI in this patient population.
  • Accurate differentiation between AIFI and HSV infections is critical due to vastly different treatment modalities.

Observation:

  • Two immunocompromised patients presented with mucosal and perinasal skin lesions.
  • The clinical manifestations of these lesions mimicked those of AIFI.
  • Distinguishing between viral and fungal infections is crucial due to differing treatment modalities.

Findings:

  • Nasal HSV infections can present with diverse clinical features that overlap with AIFI in immunocompromised patients.
  • Accurate differential diagnosis is essential to guide appropriate, disease-specific treatment.
  • Delayed diagnosis and treatment of acute invasive infections in immunocompromised hosts can lead to fatal outcomes.

Implications:

  • Clinicians must consider herpes simplex virus infections in the differential diagnosis of nasal lesions in immunocompromised patients.
  • Early and accurate differentiation between viral and fungal infections can prevent inappropriate treatment and improve patient outcomes.
  • This highlights the importance of rapid diagnostic strategies for acute infections in immunocompromised populations.
Keywords:
Differential diagnosisHerpes simplexInvasive fungal infectionsNasal cavityNose

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