Herpes simplex lymphadenitis. An unusual presentation with necrosis and viral particles

An inguinal lymph node was excised from a 23-year-old woman. Histologic examination revealed necrotic foci with cytologic changes indicative of herpes simplex virus; immunohistochemistry and electron microscopy confirmed the presence of virus. Typical cutaneous lesions appeared on the vulva three days after surgery. Focally necrotizing lymphadenitis and cytologic changes of viral transformation are unusual in herpes group infections.     

Herpes simplex lymphadenitis: a case report and review of the published work.

Viral lymphadenitis may lead to a histological appearance that can simulate malignancy. The histological features of herpes simplex lymphadenitis have not previously been described in detail. We report a case of proved herpes simplex lymphadenitis in a 30 year old man which was characterised by a pronounced proliferation of immunoblasts. The microscopical findings are described and the published work is reviewed.     

Localized herpes simplex lymphadenitis

Despite the marked immunocompromised status of most affected patients, visceral herpes simplex virus (HSV) infections in adults remain localized to the esophagus, with only rare examples of dissemination. Lymph node involvement with herpes simplex has been noted in three reported cases, but only in the context of a widespread fatal infection. This report describes two patients who presented with localized herpetic lymphadenitis documented by light microscopy, immunohistochemistry, and DNA hybridization technics.     

Herpes simplex virus lymphadenitis mimicking tumoral relapse in a patient with Hodgkin's disease in remission

Summary A patient treated for Hodgkin's disease and presenting 12 years later with a left inguinal lymphadenopathy mimicking a relapse is reported. Histopathological study disclosed large histiocytic granulomas in the sinuses. Some of these granulomas showed necrotic areas with numerous neutrophils. At the edge of the necrotic zones, cells of undetermined origin exhibited intra-nuclear inclusions typical of Herpes simplex virus. The diagnosis was confirmed by immunolabelling, revealing Herpes simplex viral antigens in frozen and paraffin sections, and by ultrastructural studies. The diagnostic value of the histological methodology and pathological changes and the significance of the disease, appearing in a patient treated for Hodgkin's disease are discussed.     

Herpes simplex oesophagitis

A patient is described with oesophageal ulceration due to herpes simplex virus type I. The endoscopic, light, electron microscopic, and immunohistochemical appearances are described and the literature of this under-diagnosed entity is reviewed.     

Herpes simplex pancreatitis

Lesions of the pancreas induced by viral infection have drawn relatively little attention because of their low incidence, and the histopathologic features of viral pancreatitis have not been fully elucidated. We report the autopsy findings of 2 patients, a 59-year-old woman with allergic granulomatous angiitis and a 73-year-old man with invasive pulmonary aspergillosis who had a disseminated visceral herpes simplex virus (HSV) infection. In both cases, the liver was the organ most severely affected by the viral infection. The pancreas showed multiple small foci of hemorrhagic necrosis, which were not accompanied by fat necrosis of the surrounding adipose tissue. Histopathologically, Cowdry type A intranuclear inclusions and a ground-glass appearance of the nuclei were found in many degenerated acinar cells around the necrotic foci. The gross appearance and histopathologic features of HSV pancreatitis were characteristic and, in particular, distinct from those of the more common acute hemorrhagic pancreatitis. Immunohistochemistry using an anti-HSV antibody revealed immunoreactivity in the intranuclear inclusions and ground-glass nuclei, and polymerase chain reaction analysis disclosed that the causative virus in these 2 cases was HSV-1. Herpes simplex virus pancreatitis constitutes a rare, but distinct pathologic entity among a group of acute pancreatitis diseases with diverse etiopathogenesis.     

Herpes simplex virus-based vectors

Herpes simplex virus (HSV)-based vectors have primarily been developed for neuronal gene delivery, taking advantage of the virus' natural neurotropism. Two types of vector are available: replication defective viruses, whose cytotoxicity has been abolished by deleting viral gene products, and amplicon vectors, which are plasmids packaged into HSV particles with the aid of a helper virus. In this review I discuss how the cytotoxicity of the wild-type virus has been abolished, the progress which has been made toward defining promoter elements capable of directing long-term transgene expression form the latent viral genome and some of the potential clinical uses of these versatile vectors.     

Herpes simplex virus infections

Infections with herpes simplex virus (HSV) are extremely common. HSV infection may be asymptomatic or may cause any one of a wide variety of disease syndromes. In this review, the physical properties and mode of replication of HSV are briefly described, and an outline of the different clinical manifestations associated with HSV infection is presented. Principles of diagnosis, treatment, and prevention of these infections are also discussed.     

Herpetic infection (Herpes simplex

Structural manifestations of Herpesviridae infection, largely of herpes simplex, transmission and mode of entry were analysed and investigated by the authors on section material using light and immunofluorescent microscopy in combination with serological tests. In overall neonatal section material generalized herpetic infection was a frequent finding (4.7%). The lesions in type I and II herpes simplex were similar in manifestations. Structural evaluation of the viscera in prenatal and placental infections suggests affection of cells of epithelial origin with metamorphosis of the giant cells and a drastic increase of the nuclei exhibiting large inclusions rich in DNA. Alternative changes were more pronounced in the brain, while the destruction of the affected cells was more intensive in the lungs. Postnatal herpes simplex virus infection was also covered.     

Zur Histopathologie des Herpes simplex

Ohne ZusammenfassungMit 2 Textabbildungen.     

Herpes simplex clinical and pathogenetic aspects

Immunologic Research - Primary infection with herpes simplex virus of either type 1 or type 2 occurs frequently, however, recurring disease develops in only a small fraction of the population....     

Herpes simplex virus infection and apoptosis

Consequences of human herpes simplex virus (HSV) infection include the induction of apoptosis and the concomitant synthesis of proteins which act to block this process from killing the infected cell. Recent data has clarified our current understanding of the mechanisms of induction and prevention of apoptosis by HSV. These findings emphasize the fact that modulation of apoptosis by HSV during infection is a multicomponent phenomenon. We review recent evidence showing how this important human pathogen modulates the fundamental cell death process.     

Rabies and Herpes simplex virus encephalitis

Summary A retrospective study on the frequency, site and distribution of rabies and Herpes simplex virus (HSV) type 1 antigens by means of immunofluorescence (IF) and immunoperoxidase (IP) techniques was performed on routinely processed (formol-fixed, paraffin-embedded) brain autopsy material stored for up to 25 years. In 2 animal and 2 human rabies cases, inclusion bodies in neuronal cytoplasm and processes were brilliantly stained for rabies antigens by IF but were much less prominent or absent in usual histological stains. In 33 cases of histopathologically diagnosed necrotizing encephalitis, HSV antigens were demonstrated in 18 of 26 acute cases; 7 subacute cases (course longer than 4 weeks) were all negative for HSV antigens. Neuronal cytoplasm and nuclear membranes were the main sites of HSV antigens; nuclear inclusion bodies were inconstantly stained. Since most of HSV antigen negative cases also showed intranuclear inclusion bodies in HE stains, such nuclear inclusions are no reliable criterion for an HSV aetiology. On the other hand, their absence does not rule out a herpetic aetiology, but such a constellation is rare (only one of 18 HSV positive cases). Distribution of cells showing a positive reaction for HSV antigens may be patchy and irregular; therefore, a false negative result must be expected if very small tissue samples are examined (e.g, in needle biopsies from temporal lobe). In the leptomeninges, HSV antigen positive cells were found inconstantly and only in small numbers; this finding makes unlikely the possibility of an intravital diagnosis of HSV encephalitis by immunostaining of cerebrospinal fluid (CSF) cell preparations. Both immunohistological techniques applied in this study (IF and IP) gave the same results. Imprint preparations are useful when quick diagnosis is necessary.Immunohistological investigations are a simple and effective means to demonstrate a viral aetiology even in routinely processed material; the use of such material rules out hazards in laboratories which are not designed to handle highly infectious fresh material.     

Herpes simplex virus and toll-like receptors

The earliest interactions between viruses and host cells are critical to determining the outcome of infections. The interactions between a virus and its host cells that lead to the production of inflammatory cytokines are essential to the development of T cells and antibodies that provide long-term defense against the invaders. At the same time, however, these same cytokines (or sometimes other mediators or chemokines) stimulate inflammation, which may lead to localized tissue damage and/or systemic circulatory collapse and death. This review focuses on the interaction between Toll-like receptors, a critical component of the innate immune system of mammals, and their role in herpes simplex pathogenesis and immunity.     

Herpes simplex infection in urothelial carcinoma

Herpes simplex virus (HSV), a member of the Herpesviridae family, is a very common pathogen that can infect any site in the body. Urothelial carcinoma (UC) is a common malignancy of the urinary tract. The possibility of HSV infection in cases of UC has attracted little attention. In this study, we investigated the possible presence of HSV in UC and non-neoplastic urothelium. We examined the incidence of HSV infection in 100 samples of UC from 78 patients and 50 samples of non-neoplastic urothelium from 50 autopsy cases using immunohistochemical staining and amplification of DNA using polymerase chain reaction (PCR). Infection by HSV was detected in 39 of the 100 samples of UC (35 of 78 patients) using immunohistochemical staining and/or PCR analysis, in marked contrast with 1 of 50 samples of non-neoplastic urothelium. There was no significant relationship between infection by HSV and anatomical site, growth pattern or depth of invasion of UC, but the frequency of HSV infection was significantly higher in females than in males. Our findings indicate that UCs become infected with HSV much more easily than non-neoplastic urothelium.     

Differences in the mechanism of induction of interferon-alpha by Herpes simplex virus and Herpes simplex virus-infected cells

Summary The cellular source of IFN alpha after induction with Herpes simplex virus type-1 (HSV) and HSV-infected fibroblasts was investigated by using human peripheral blood mononuclear cell (PBMC) populations, purified according to conventional procedures, and which included T- and B-lymphocytes as well as monocytes. It appears that the cells responding to HSV virions are monocytes, whereas the PBMC population induced by HSV-infected cells is represented by B-lymphocytes. Furthermore, by using monoclonal antibody (MoAb) to HLA class I and class II products, it appears that different membrane structures are involved in the induction of IFN by HSV virions, as opposed to HSV-infected cells. In fact, most anti-HLA class II MoAbs inhibit IFN induction by HSV-infected cells, and not IFN induction by HSV virions.     

Immunity in latent Herpes simplex virus infection

Immune responses against productive Herpes simplex virus 1 (HSV-1) and/or Herpes simplex virus 2 (HSV-2) (HSV) infection together with associated immune escape mechanisms are to a great degree understood. Due to a limited RNA expression and lacking a convincing evidence for production of virus proteins during latency, HSV in latently infected neurons had been for a long period considered invisible to immune system. This review analyzes currently accumulating data indicating an important role of immune response to HSV-1 latency and/or to early steps of HSV-1 reactivation process. Although this review focuses on HSV-1, it is likely that general concepts apply to both HSV-1 and HSV-2, since they share a great deal of similarity in their biological features including a high degree of sequence similarity at the nucleic acid level.     

Herpes simplex hepatitis in apparently immunocompetent adults

A study of eight cases of herpes simplex hepatitis in apparently immunocompetent adults is presented. The clinical features were nonspecific and were usually those of a severe systemic infection, mimicking septic shock. However, the histologic features were distinctive, with randomly distributed patchy areas of coagulative necrosis surrounded by hepatocytes containing viral inclusions. Viral particles could be identified by electron microscopy and Herpes simplex antigens by immunohistochemistry, but these were not necessary for diagnosis. The light microscopic morphologic features are so distinctive that if these are recognized in a biopsy, the diagnosis of herpetic hepatitis can be made and anti-viral therapy may be instituted.