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Acute Necrotizing Herpetic Tonsillitis: A Report of Two Cases

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Abstract

The finding of herpetic tonsillitis is rare. Tonsillectomies are usually done for children with recurrent chronic tonsillitis, while viral throat infections are generally self-limiting. We present two cases: A 5 year-old girl, with atypical hemolytic anemia managed with Eculizumab, who presented with a pharyngeal infection and tonsillar enlargement that did not respond to intravenous antibiotics or antifungal therapies; and a 30 year-old man who presented with upper airway obstruction and fever; bilateral tonsillectomies were performed. Histopathological examination showed a necrotizing tonsillitis with numerous ground-glass intranuclear inclusions, characteristic of herpes viral infection, further confirmed by Herpes simplex virus in situ hybridization. Both patients were managed by intravenous Acyclovir, with dramatic improvement.

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References

  1. Walker AE, Grimshaw JM, Armstrong EM. Salient beliefs and intentions to prescribe antibiotics for patients with a sore throat. Br J Health Psychol. 2001;6:347–60.

    Article  PubMed  Google Scholar 

  2. Putto A. Febrile exudative tonsillitis: viral or streptococcal? Pediatrics. 1987;80:6–12.

    CAS  PubMed  Google Scholar 

  3. Taylor TJ, Brockman MA, McNamee EE, Knipe DM. Herpes simplex virus. Front Biosci. 2002;7:d752–64.

    Article  CAS  PubMed  Google Scholar 

  4. Whitley RJ. Herpes simplex virus infection. Semin Pediatr Infect Dis. 2002;13:6–11.

    Article  PubMed  Google Scholar 

  5. Chen T, Hudnall SD. Anatomical mapping of human herpesvirus reservoirs of infection. Mod Pathol. 2006;19(5):726–37.

    Article  Google Scholar 

  6. Arduino PG, Porter SR. Herpes simplex virus type 1 infection: overview on relevant clinico-pathological features. J Oral Pathol Med. 2008;37:107–21.

    Article  PubMed  Google Scholar 

  7. Vassallo J, Camargo LA, Chagas CA, et al. Search for herpesvirus 1 and 2 by in situ hybridization in tonsils and adenoids. Int J Pediatr Otorhinolaryngol. 2005;69:345–9.

    Article  PubMed  Google Scholar 

  8. Karlidag T, Bulut Y, Keles E, et al. Presence of herpesviruses in adenoid tissues of children with adenoid hypertrophy and chronic adenoiditis. Kulak Burun Bogaz Ihtis Derg. 2012;22:32–7.

    Article  PubMed  Google Scholar 

  9. Brooke AE, Eveson JW, Luker J, Oakhill A. Oral presentation of a novel variant of herpes simplex infection in a group of bone marrow transplant patients: a report of five cases. Br J Dermatol. 1999;141:381–3.

    Article  CAS  PubMed  Google Scholar 

  10. Wat PJ, Strickler JG, Myers JL, Nordstrom MR. Herpes simplex infection causing acute necrotizing tonsillitis. Mayo Clin Proc. 1994;69:269–71.

    Article  CAS  PubMed  Google Scholar 

  11. Gonen C, Uner A, Cetinkaya Y, et al. Tonsillar abscess formation due to herpes simplex type-1 in a severely immunocompromised stem cell transplant patient with chronic myeloid leukemia. Transpl Infect Dis. 2006;8:166–70.

    Article  CAS  PubMed  Google Scholar 

  12. Tanaka N. Infection of herpes simplex virus (HSV) and Epstein–Barr virus (EBV) in acute tonsillitis—histopathological assessment by optical and electron microscopic observation of biopsy specimens of tonsils. Nihon Jibiinkoka Gakkai Kaiho. 2001;104:1093–102.

    Article  CAS  PubMed  Google Scholar 

  13. Strickler JG, Manivel JC, Copenhaver CM, Kubic VL. Comparison of in situ hybridization and immunohistochemistry for detection of cytomegalovirus and herpes simplex virus. Hum Pathol. 1990;21:443–8.

    Article  CAS  PubMed  Google Scholar 

  14. Rusan M, Klug TE, Henriksen JJ, et al. The role of viruses in the pathogenesis of peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2012;31:2335–43.

    Article  CAS  PubMed  Google Scholar 

  15. Young EJ, Vainrub B, Musher DM, et al. Acute pharyngotonsillitis caused by Herpesvirus type 2. JAMA. 1978;239:1885–6.

    Article  CAS  PubMed  Google Scholar 

  16. Espy MJ, Uhl JR, Mitchell PS, et al. Diagnosis of herpes simplex virus infections in the clinical laboratory by LightCycler PCR. J Clin Microbiol. 2000;38:795–9.

    PubMed Central  CAS  PubMed  Google Scholar 

  17. Sahin F, Gerceker D, Karasartova D, Ozsan TM. Detection of herpes simplex virus type 1 in addition to Epstein–Bar virus in tonsils using a new multiplex polymerase chain reaction assay. Diagn Microbiol Infect Dis. 2007;57:47–51.

    Article  CAS  PubMed  Google Scholar 

  18. Baxte S, Steid K, Probs L, Listman J. 19th Annual Meeting Abstracts: Treatment of atypical hemolyticuremic syndrome with Eculizumab in a 10 month old child. J Pediatr Pharmacol Ther. 2010;15:203–38.

    Google Scholar 

  19. Schrezenmeier H, Hochsmann B. Drugs that inhibit complement. Transfus Apher Sci. 2012;46:87–92.

    Article  PubMed  Google Scholar 

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Correspondence to Walaa M. Borhan.

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Borhan, W.M., Dababo, M.A., Thompson, L.D.R. et al. Acute Necrotizing Herpetic Tonsillitis: A Report of Two Cases. Head and Neck Pathol 9, 119–122 (2015). https://doi.org/10.1007/s12105-013-0516-2

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  • DOI: https://doi.org/10.1007/s12105-013-0516-2

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