A Supraglottic Pseudotumor in an Immunocompromised Patient with Nephrotic Syndrome, Herpes Zoster, and a Cytomegalovirus Infection

Author:

Akimoto Tetsu1,Yamazaki Tomoyuki1,Saito Osamu1,Muto Shigeaki1,Kusano Eiji1,Nagata Daisuke1

Affiliation:

1. Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan.

Abstract

Several viral infections may occasionally induce supraglottic mass lesions, resulting in an obstructive airway emergency. We herein report one such case in a 63-year-old male immunocompromised patient with nephrotic syndrome due to membranous nephropathy who also had ophthalmic herpes zoster with a laryngeal mass, which required urgent intubation and mechanical ventilation. The patient was initially treated with acyclovir; however, because a serological analysis revealed a concurrent cytomegalovirus infection, we discontinued the administration of acyclovir and gave priority to the simultaneous treatment of the cytomegalovirus and varicella-zoster virus infections with ganciclovir. The clinical course was favorable, and he was weaned from the ventilator 10 days later when a serial imaging analysis revealed no signs of the supraglottic mass, leading us to conclude that these two viral infections could have additively or synergistically contributed to the development of the local pseudotumor. The diagnostic and therapeutic concerns arising in the current case are also discussed.

Publisher

SAGE Publications

Subject

General Medicine

Cited by 5 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. CMV-associated Laryngeal Lesion in an Infant;Otolaryngology Case Reports;2022-11

2. Cytomegalovirus-associated supraglottic mass in a patient on immunosuppressive therapy;South African Medical Journal;2021-06-30

3. Nonsquamous Pathologic Diseases of the Hypopharynx, Larynx, and Trachea;Gnepp's Diagnostic Surgical Pathology of the Head and Neck;2021

4. Acquired von Willebrand Syndrome Complicating Nephrotic Syndrome: A Case of a Patient With Membranous Nephropathy;Clinical Medicine Insights: Case Reports;2018-01-01

5. Bilateral herpes zoster in a patient with end-stage kidney disease;International Medical Case Reports Journal;2017-06

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