In immunocompromised patients, oral ulcerations are common and have a wide spectrum of causes, including herpesvirus infection. We report on a case in which an oral ulcer was simultaneously infected by herpes simplex (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) in a kidney-pancreas transplant recipient. A 46-year-old woman presented with a clinically nonspecific dorsal tongue ulcer of 3 months duration. Histopathologic evaluation indicated keratinocytes exhibiting herpetic viral cytopathic effect. Nuclear and cytologic alterations suggestive of CMV infection were found in endothelial cells subjacent to the ulcer. Immunohistochemistry testing for HSV and CMV was positive in these cells. Large atypical mononuclear cells were also evident in the ulcer bed's inflammatory infiltrate, which had intense nuclear positivity for Epstein-Barr encoding region in situ hybridization. We believe this is the first well-documented report of the definitive concomitant presence of HSV, CMV, and EBV in an immunocompromised patient. Although the pathogenesis of coinfected ulcers remains unknown, a synergistic effect is possible.
机构:
Univ Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Richardson, Ann K.
Currie, Margaret J.
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Univ Otago, Mackenzie Canc Res Grp, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Currie, Margaret J.
Robinson, Bridget A.
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Univ Otago, Mackenzie Canc Res Grp, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Robinson, Bridget A.
Morrin, Helen
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Univ Otago, Mackenzie Canc Res Grp, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Morrin, Helen
Phung, Yen
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Univ Otago, Mackenzie Canc Res Grp, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Phung, Yen
Pearson, John F.
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Univ Otago, Biostat & Computat Biol Unit, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Pearson, John F.
Anderson, Trevor P.
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Canterbury Hlth Labs, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Anderson, Trevor P.
Potter, John D.
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Univ Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98104 USA
Massey Univ, Ctr Publ Hlth Res, Wellington, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
Potter, John D.
Walker, Logan C.
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Univ Otago, Mackenzie Canc Res Grp, Christchurch, New ZealandUniv Canterbury, Sch Hlth Sci, Wayne Francis Canc Epidemiol Res Grp, Christchurch 1, New Zealand
机构:
Univ Fed Pernambuco, Oral Med Unit, Dept Clin & Odontol Prevent, BR-50670901 Recife, PE, BrazilUniv Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
Tenorio de Franca, Talita Ribeiro
Tavares Carvalho, Alessandra de Albuquerque
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Univ Fed Pernambuco, Oral Med Unit, Dept Clin & Odontol Prevent, BR-50670901 Recife, PE, BrazilUniv Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
Tavares Carvalho, Alessandra de Albuquerque
Gomes, Valder Barbosa
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Univ Fed Pernambuco, Oral Med Unit, Dept Clin & Odontol Prevent, BR-50670901 Recife, PE, BrazilUniv Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
Gomes, Valder Barbosa
Gueiros, Luiz Alcino
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Univ Fed Pernambuco, Oral Med Unit, Dept Clin & Odontol Prevent, BR-50670901 Recife, PE, BrazilUniv Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
Gueiros, Luiz Alcino
Porter, Stephen Ross
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Univ London, Eastman Dent Inst, Oral Med Unit, Div Maxillofacial Diagnost Surg & Med Sci, London, EnglandUniv Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
Porter, Stephen Ross
Leao, Jair Carneiro
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Univ Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
Univ Fed Pernambuco, Oral Med Unit, Dept Clin & Odontol Prevent, BR-50670901 Recife, PE, BrazilUniv Fed Pernambuco, Programa Posgrad Odontol, BR-50670901 Recife, PE, Brazil
机构:
Louisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Louisiana State Univ Hlth, Dept Internal Med, 1541 Kings Highway, Shreveport, LA 71103 USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Sharma, Shivani
Ulicny, Joseph
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Louisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Ulicny, Joseph
Thuzar, Moe
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Louisiana State Univ Hlth Shreveport, Dept Pathol, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Thuzar, Moe
Aguiar, Roberto Silva
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Louisiana State Univ Hlth Shreveport, Dept Pathol, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Aguiar, Roberto Silva
Sharkey, Sarah
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Louisiana State Univ Hlth, Dept Pulm & Crit Care Med, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Sharkey, Sarah
Zhang, Frank
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Louisiana State Univ Hlth, Dept Pulm & Crit Care Med, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Zhang, Frank
Chambers, David
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Louisiana State Univ Hlth, Dept Pulm & Crit Care Med, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
Chambers, David
Malek, Alexandre E.
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Louisiana State Univ Hlth Shreveport, Div Infect Dis, Dept Pediat, Shreveport, LA USALouisiana State Univ Hlth, Dept Internal Med, Shreveport, LA USA
机构:
Mexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Duque, Ximena
Mendoza, Eugenia
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Mexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Mendoza, Eugenia
Moran, Segundo
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Mexican Inst Social Secur, Gastroenterol Res Lab, Mexico City 06725, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Moran, Segundo
Suarez-Arriaga, Mayra C.
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机构:
Childrens Hosp Mex Federico Gomez, Res Unit Virol & Canc, Mexico City 06720, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Suarez-Arriaga, Mayra C.
Morales-Sanchez, Abigail
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Childrens Hosp Mex Federico Gomez, Res Unit Virol & Canc, Mexico City 06720, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Morales-Sanchez, Abigail
Fontes-Lemus, Jose I.
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Childrens Hosp Mex Federico Gomez, Res Unit Virol & Canc, Mexico City 06720, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Fontes-Lemus, Jose I.
Dominguez-Martinez, Diana A. A.
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Childrens Hosp Mex Federico Gomez, Res Unit Virol & Canc, Mexico City 06720, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
Dominguez-Martinez, Diana A. A.
Fuentes-Panana, Ezequiel M.
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Childrens Hosp Mex Federico Gomez, Res Unit Virol & Canc, Mexico City 06720, MexicoMexican Inst Social Secur, Infect Dis Res Unit, Mexico City 06725, Mexico
机构:
Departmento de Patologia, Centro Clinico de Cabeza e Cuello, GuatemalaDepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
Carlos R.
Thompson L.D.R.
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Department of Pathology, Southern California Permanente Medical Group, Woodland Hills, CADepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
Thompson L.D.R.
Netto A.C.
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Departmento de Patologia, Centro Clinico de Cabeza e Cuello, GuatemalaDepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
Netto A.C.
Pimenta L.G.G.S.
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Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MGDepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
Pimenta L.G.G.S.
de Fátima Correia-Silva J.
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机构:
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MGDepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
de Fátima Correia-Silva J.
Gomes C.C.
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Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MGDepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
Gomes C.C.
Gomez R.S.
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机构:
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG
Departamento de Patologia e Cirurgia, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG CEP 31270-901, Av. Antonio CarlosDepartmento de Patologia, Centro Clinico de Cabeza e Cuello, Guatemala
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Matsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Kasamatsu, Hashima, 185-1 Dendai, Gifu 5016062, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Kato, Moe
Lee, Shin
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机构:
Matsunami Gen Hosp, Dept Hematol, Gifu, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Lee, Shin
Morishita, Tetsuji
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Matsunami Gen Hosp, Dept Gen Internal Med, Gifu, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Morishita, Tetsuji
Fujita, Kei
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机构:
Matsunami Gen Hosp, Dept Hematol, Gifu, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Fujita, Kei
Tagami, Atsushi
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机构:
Matsunami Gen Hosp, Dept Gastroenterol & Hepatol, Gifu, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Tagami, Atsushi
Araki, Hiroshi
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机构:
Matsunami Gen Hosp, Dept Gastroenterol & Hepatol, Gifu, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan
Araki, Hiroshi
Sugihara, Jun-ichi
论文数: 0引用数: 0
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机构:
Matsunami Gen Hosp, Dept Gastroenterol & Hepatol, Gifu, JapanMatsunami Gen Hosp, Dept Gen Internal Med, Gifu, Japan