ARDS CAUSED BY HERPES-SIMPLEX VIRUS PNEUMONIA IN A PATIENT WITH CROHNS-DISEASE - A CASE-REPORT

Pneumonia caused by herpes simplex virus type 1 (HSV1) is rare and occ urs in severely immunosuppressed patients. HSV1 can be detected in bro nchoalveolar lavage (BAL) from patients presenting with respiratory fa ilure, but its direct effect on disease is difficult to prove. We demo nstrate the causative role of HSV1 in the case of a 44-year-old male w ith Crohn's disease who presented to the intensive care unit with the acute respiratory distress syndrome after surgery. BAL cells were cult ured and immunofluorescence confirmed the presence of HSV1 during the first weeks of illness. Increased IgG titers confirmed the diagnosis o f a recurrent HSV1 infection. A lung biposy specimen showed fibroproli feration without pathogens. Immunosuppressive therapy had been stopped and acyclovir was introduced at this time. The diagnostic difficultie s in this patient underline the importance of early recognition of vir al infection as a potential cause of severe pneumonia in severely ill, immunocompromised patients.