Lung - nontumor
Infections
Herpes simplex pneumonia

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 24 February 2017, last major update September 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: herpes simplex [title] pneumonia

Related topics: neonatal HSV pneumonia

Cite this page: Herpes simplex pneumonia. PathologyOutlines.com website. http://pathologyoutlines.com/topic/lungnontumorHSV.html. Accessed April 24th, 2017.
Definition / General
  • Herpes simplex virus (HSV), serotypes HSV-1 and HSV-2, cause acute infection followed by latent phase that may reactivate to infectious form
  • See also Skin - nontumor chapter
  • HSV-1 and HSV-2 are alpha group herpes viruses with similar genotypes but serologic differences; may both infect the lung
  • HSV-1 usually affects oral pharynx; HSV-2 usually causes genital infection
  • Virus spreads via sensory neurons where latent infection is established
  • Reactivation may be symptomatic or asymptomatic, virus spreads via nerves to mucus membranes or skin, where it replicates
  • Newborns (see below), patients with impaired mucosal defenses, burn patients, trauma patients, and severely immunocompromised patients are at greatest risk
  • Also associated with coexisting bacterial pneumonia (J Crit Care 2011;26:432.e1)
  • Also be caused by intubation of patient with active oral disease
  • Immunostains, PCR, culture or electron microscopy can confirm the diagnosis if necessary
Gross Description
  • Diffusely firm lungs with small yellow / red necrotic areas
Gross Images

Images hosted on other servers:

Various images

Micro Description
  • Interstitial pneumonia with necrosis of bronchial and alveolar epithelium and acute and chronic inflammatory infiltrate
  • Occasional intranuclear viral inclusions at edge of necrotic areas
  • Neutrophilic infiltrates may resemble bacterial bronchopneumonia, but Cowdry type A or B nuclear inclusions are generally diagnostic
Micro Images

Images hosted on other servers:

Immunostain highlights
HSV+ cell in broncheo-
alveolar lavage