Herpes Simplex Virus Type 1 with Concomitant Pneumonia and Urinary Tract Infection in an Older Patient: A Case Report

Abstract

A 76-year-old female patient was unable to ambulate due to sequelae of cerebrovascular disease and had been living in a healthcare facility. On admission, the patient was diagnosed with sepsis and a urinary tract infection caused by Candida tropicalis. Chest radiography showed right lung atelectasis, while bronchoscopy showed bronchial stenosis with anthracotic pigmentation in both bronchi. Bronchial washing cytology revealed herpes simplex virus (HSV) type 1-infected cells with intranuclear inclusions and multinucleation on the 7th day. Moreover, the patient showed microscopic hematuria. Urine cytology also revealed HSV type 1-infected cells. The patient was treated with antiviral (acyclovir), antifungal, and antibiotic agents. One week later, follow-up urine cytology revealed the absence of HSV infection, and her condition was stabilized. However, her clinical condition deteriorated due to an infection caused by multidrug-resistant bacterial pathogens, and she eventually died 4 weeks after admission. We describe a case of HSV type 1 pneumonia and urinary tract infection in an older adult patient.