Herpes simplex virus of the nose masquerading as invasive fungal sinusitis: A pediatric case series

Am J Otolaryngol. 2019 Jul-Aug;40(4):609-611. doi: 10.1016/j.amjoto.2019.05.012. Epub 2019 May 14.

Abstract

The management of invasive fungal sinusitis differs greatly from the management of herpes simplex virus (HSV) of the nose in immunocompromised patients. However, the diagnosis may be uncertain and a delay in treatment can lead to mortality. Here we describe the successful medical management of a series of immunocompromised pediatric patients with HSV lesions of the nose with the initial concern for invasive fungal sinusitis. The diagnosis of HSV herpes was supported by positive polymerase chain reaction (PCR) testing of the nasal lesion. To our knowledge, these are the first cases described in the pediatric literature, emphasizing the need to include this entity on the differential.

Keywords: Herpes simplex virus; Immunocompromised; Invasive fungal sinusitis; Leukemia; Lymphoma; Nasal; Nasal herpes.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / administration & dosage
  • Adolescent
  • Adult
  • Antiviral Agents / administration & dosage
  • Child
  • Diagnosis, Differential
  • Female
  • Herpes Simplex / diagnosis*
  • Herpes Simplex / pathology
  • Herpes Simplex / therapy
  • Herpes Simplex / virology
  • Humans
  • Immunocompromised Host
  • Infusions, Intravenous
  • Invasive Fungal Infections / pathology
  • Leukemia, B-Cell
  • Male
  • Nose Diseases / diagnosis*
  • Nose Diseases / pathology
  • Nose Diseases / therapy
  • Nose Diseases / virology
  • Paranasal Sinuses
  • Polymerase Chain Reaction
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Sinusitis / microbiology
  • Sinusitis / pathology
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Acyclovir