Herpes simplex virus presenting as an oropharyngeal mass
Evgeniya Molotkova1, Anna C Buhle1, Patrick S Rush2,3
1Virginia Tech Carilion School of Medicine Roanoke Virginia USA.
Laryngoscope Investigative Otolaryngology
|December 23, 2024
Summary
This case highlights a rare instance of human simplex virus (HSV) supraglottitis in an immunocompetent patient. Early diagnosis and treatment with acyclovir led to complete resolution of the pharyngeal mass.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Virology
Background:
- Immunocompetent individuals can develop severe upper airway infections.
- Pharyngeal masses can present with concerning symptoms like dyspnea and hemoptysis.
- Distinguishing viral from neoplastic causes of pharyngeal masses can be challenging.
Purpose of the Study:
- To present a complex case of human simplex virus (HSV) supraglottitis.
- To emphasize diagnostic challenges in immunocompetent patients.
- To illustrate the successful treatment of a rare pharyngeal infection.
Main Methods:
- Case report of a single immunocompetent 74-year-old male patient.
- Clinical presentation, laryngoscopy findings, and biopsy results were analyzed.
- Diagnostic workup included bacterial and viral testing (PCR).
Main Results:
- A large, fungating pharyngeal mass was identified.
- Initial biopsies were nonspecific; cultures revealed *Fusobacterium necrophorum*.
- Human simplex virus (HSV) infection was confirmed via PCR, and treatment with acyclovir led to complete mass resolution.
Conclusions:
- Human simplex virus (HSV) supraglottitis is a rare, aggressive condition.
- Diagnosis is often delayed due to non-specific findings and mimicry of other diseases.
- Concurrent bacterial infection can exacerbate HSV supraglottitis severity.
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