Oral ulceration associated with concurrent herpes simplex virus, cytomegalovirus, and Epstein-Barr virus infection in an immunocompromised patient

被引:12
|
作者
Mainville, Gisele N. [1 ]
Marsh, William L. [2 ]
Allen, Carl M. [3 ]
机构
[1] Univ Montreal, Fac Med Dent, Dept Stomatol, Montreal, PQ H3C 3J7, Canada
[2] Ohio State Univ, Wexner Med Ctr, Dept Pathol & Lab Med, Columbus, OH 43210 USA
[3] Ohio State Univ, Coll Dent, Div Oral & Maxillofacial Pathol & Radiol, Columbus, OH 43210 USA
来源
ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY | 2015年 / 119卷 / 06期
关键词
POSITIVE MUCOCUTANEOUS ULCER; LYMPHOMATOID GRANULOMATOSIS; HAIRY LEUKOPLAKIA; EBV; MANIFESTATIONS; HERPESVIRIDAE; EPIDEMIOLOGY; TRANSMISSION; INVOLVEMENT; REJECTION;
D O I
10.1016/j.oooo.2014.10.019
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
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.
引用
收藏
页码:E306 / E314
页数:9
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