Table of Contents Author Guidelines Submit a Manuscript
Canadian Journal of Gastroenterology
Volume 19 (2005), Issue 6, Pages 367-371
http://dx.doi.org/10.1155/2005/516217
Brief Communication

Herpes Simplex Virus Type II Infection of Ileum Mesothelium: A Case Report and Review of the Literature

SAC Medlicott,1 VG Falck,1 KB Laupland,2 M Akbari,1 and PL Beck2

1Department of Pathology and Laboratory Medicine, Peter Lougheed and Foothills Medical Centres, Calgary, Alberta, Canada
2Department Internal Medicine, Peter Lougheed and Foothills Medical Centres, Calgary, Alberta, Canada

Received 7 December 2004; Accepted 28 March 2005

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Disseminated herpes simplex virus (HSV) infection usually manifests in the immunocompromised. However, anecdotal examples of visceral HSV disease and viremia have complicated type I diabetes. A case of a 53-year-old type I diabetic patient with bowel obstruction one week subsequent to bronchitis is reported. At laparotomy, a perforated segment of ileum was associated with an adhesive peritoneal band. HSV cytopathic atypia and HSV immunohistochemical staining were confined to fibrocytes and mesothelial cells without involvement of the epithelium. Dissemination of symptomatic HSV pneumonia was verified by histology, immunohistochemistry, in situ hybridization, polymerase chain reaction and direct fluorescence antibody. Intravenous acyclovir resolved symptoms. This is a novel documentation of HSV complicating ileal adhesive band disease. Furthermore, this case indicates that the HSV cytopathic effect is not unique to the epithelium. Disseminated infection can manifest in myofibrocytes and mesothelium, distinguishing it from standard epithelial atypia of localized HSV infection.