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Herpes simplex virus (HSV) colitis in a bone marrow transplant recipient
1Division of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Bone Marrow Transplantation
|February 1, 1996
Summary
Herpes simplex virus (HSV) colitis is rare in bone marrow transplant patients. This case highlights successful treatment of concurrent HSV, cytomegalovirus, Clostridium difficile, and graft-versus-host disease in a transplant recipient.
Area of Science:
- Infectious Diseases
- Hematology
- Transplantation Medicine
Background:
- Bone marrow transplantation (BMT) patients are immunocompromised, increasing susceptibility to opportunistic infections.
- Herpes simplex virus (HSV) infections are common post-BMT, but colonic involvement is infrequent.
- Distinguishing HSV colitis from other causes like cytomegalovirus (CMV), Clostridium difficile, and graft-versus-host disease (GVHD) is clinically challenging.
Observation:
- A patient undergoing allogeneic BMT developed severe colonic symptoms.
- Diagnostic workup revealed a complex co-infection involving HSV, CMV, and C. difficile, alongside acute GVHD.
- The clinical presentation mimicked other forms of infectious colitis and GVHD.
Findings:
- Histopathological examination confirmed HSV in colonic biopsies.
- The patient was diagnosed with a rare case of multifactorial colitis.
- Successful treatment involved a multi-pronged approach targeting all identified pathogens and GVHD.
Implications:
- This case underscores the importance of considering rare etiologies like HSV colitis in BMT recipients with gastrointestinal symptoms.
- Prompt and comprehensive diagnosis is crucial for effective management of co-infections and GVHD.
- Successful treatment strategies can be developed even in complex, multifactorial cases, improving patient outcomes.