acyclovir and Laryngitis

The most common presentation of herpes zoster in the head and neck region is called Ramsay Hunt syndrome (RHS), which rarely accompanies multiple cranial neuropathy. Herpes zoster also involves the mucous membrane of the tongue, palate, pharynx, and larynx. Herpes zoster infection of the larynx accompanied by Ramsay Hunt syndrome with cranial polyneuropathy is extremely rare, with only few reported cases in the literature. At the time of this report, a review of the medical literature disclosed 4 reported cases of herpes zoster laryngitis accompanied by Ramsay Hunt syndrome. Herein, we present 2 additional cases and report the clinical outcome of cranial polyneuropathy with a review of the literature.

Topics: Acyclovir; Aged, 80 and over; Antiviral Agents; Drug Therapy, Combination; Female; Glucocorticoids; Herpes Zoster Oticus; Humans; Laryngitis; Laryngoscopy; Magnetic Resonance Imaging; Male; Middle Aged; Prednisone

Herpetic laryngitis is a rare inflammatory disease caused by herpes simplex or herpes zoster virus. The propensity for spreading along peripheral nerves and within the central nervous system, with frank herpetic meningoencephalitis, is a rare complication. We present one case of herpetic laryngitis by reactivation of varicella zoster, with central nervous system spreading, and discuss the relevant literature on the pathophysiology, diagnosis, evaluation, and management of this disease.

Topics: Acyclovir; Aged; Antiviral Agents; Female; Herpes Zoster; Humans; Laryngitis; Laryngoscopy; Magnetic Resonance Imaging

A newborn presented 1 week after birth with the sudden onset of stridor and respiratory distress. At endoscopy, the supraglottic and subglottic tissues were edematous and erythematous, and numerous plaquelike ulcers were seen on the mucosal surface. Cultures of the lesions yielded herpes simplex virus type 2. The infant required a prolonged course of acyclovir and remained intubated for 31 days, but ultimately had both virological and clinical cure. Evaluation and further treatment of this unusual presentation of herpes simplex virus are discussed, as are the implications of herpes infections in neonates.

Topics: Acyclovir; Bronchoscopy; Drug Resistance, Microbial; Herpesviridae Infections; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Laryngitis; Laryngoscopy; Male; Oxygen Inhalation Therapy; Respiration, Artificial; Respiratory Insufficiency; Tracheitis; Virus Shedding

Topics: Acyclovir; Antiviral Agents; Child; Diagnosis, Differential; Herpes Zoster; Herpesvirus 3, Human; Humans; Laryngitis; Larynx; Lymphadenopathy; Male; Pharyngitis; Pharynx; Tomography, X-Ray Computed; Treatment Outcome

Laryngopharyngeal herpes simplex virus infection is rare and presents typically in the supraglottis. Findings on presentation can range from small mucosal lesions to fungating obstructive masses mimicking neoplasm. Laryngopharyngeal herpes is a medically treated disease.. Identify potential treatment in cases that are refractory to antiviral medications.. Individual case with treatment adapted from other case report.. We report a case of bulky, obstructive supraglottic and glottic herpes virus laryngitis that presented with dysphonia, dysphagia, and airway complaints resistant to acyclovir analogues that was treated effectively with intralesional cidofovir injection.. Our promising initial response suggests a potential novel treatment for this unusual condition.

Topics: Acyclovir; Antiviral Agents; Cidofovir; Herpes Simplex; Humans; Injections, Intralesional; Laryngitis; Male; Middle Aged

Topics: Acyclovir; Diagnosis, Differential; Dyspnea; Herpes Simplex; Herpesvirus 1, Human; Humans; Immunosuppressive Agents; Laryngitis; Laryngostenosis; Larynx; Male; Middle Aged; Multiple Myeloma; Tracheotomy; Treatment Outcome; Valacyclovir

Herpes simplex virus (HSV) laryngitis is rare in adults. We add a case report to the literature and perform a literature review to further delineate the clinical presentation, course, and treatment of HSV laryngitis in adults.. Case report and literature review using PubMed and Ovid databases.. Ten cases of diagnosed HSV laryngitis in adults were reported in the literature. It is more common in immunocompromised patients. The mean patient age was 51 years with a male to female ratio of 1:1. The clinical presentation and course of HSV laryngitis is variable. Patients may have mild chronic symptoms, such as dysphonia, or a fulminant course with rapid airway compromise. On laryngoscopic exam, the most common findings are a white exudate or ulceration. The most common treatment is with antiviral medication, such as acyclovir, which tends to be highly effective.. Herpes simplex virus laryngitis is rare. Clinical presentation of HSV laryngitis is variable, and its course may be indolent or fulminant. Treatment with antiviral medication tends to be highly effective.

Topics: Acyclovir; Administration, Intravenous; Aged; Airway Obstruction; Antiviral Agents; Female; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Laryngitis; Laryngoscopy; Respiration, Artificial; Treatment Outcome; Virus Diseases

Development of treatment with immunomodulatory agents has improved prognosis of various autoimmune-related diseases. A sphingosin-1-phosphate receptor modulator, or fingolimod, is the first licensed oral drug for relapsing-remitting multiple sclerosis. The agent reduces circulating lymphocytes by trapping T cells in lymph nodes, possibly leading to reactivation of latent viruses. A 41-year-old Japanese woman who had been treated with fingolimod for 2 years presented with unilateral sore throat. Laryngoscopy revealed exudates unilaterally emerging on the left side of her supraglottic region. Serum level of the varicella zoster virus (VZV)-specific IgG was markedly elevated, and a result of genome sequence using the exudates demonstrated VZV as a possible causative pathogen. Fingolimod therapy was discontinued and the patient was successfully treated with intravenous acyclovir. This is the first reported case of fingolimod-associated herpes zoster laryngitis, in which the local VZV reactivation was demonstrated by next-generation sequencing technology. The present case highlights that the occurrence of VZV reactivation should be recalled in any patients undergoing fingolimod therapy.

Topics: Acyclovir; Adult; Female; Fingolimod Hydrochloride; Herpes Zoster; Humans; Immunosuppressive Agents; Laryngitis; Virus Activation

Topics: Acyclovir; Adult; Deglutition Disorders; Diagnosis, Differential; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Laryngitis; Laryngoscopy; Pain; Pharyngitis; Virus Activation

A 73-year-old man presented to our hospital with a sore throat (left-sided) and hiccups. The patient had mucosal swelling and erosions affecting the left posterior pillar, base of tongue, epiglottis, arytenoid, and aryepiglottic fold. As the laryngeal mucosal edema became worse, herpetic vesicles and erosions developed on the left cavum conchae, external auditory canal, and palate. The patient was treated with acyclovir and a steroid. His hiccups were treated with metoclopramide, but it had little effect, and hiccups only subsided gradually after the disappearance of erosions. His hiccups relapsed transiently with vomiting, and then resolved completely. Elevation of the CF titer after 2 weeks confirmed the diagnosis of herpes zoster. This condition should be considered in patients with unilateral sore throat and intractable hiccups, and treatment with acyclovir should be provided.

Topics: Acyclovir; Administration, Oral; Aged; Anti-Inflammatory Agents; Antiviral Agents; Diarrhea; Edema; Herpes Zoster; Hiccup; Humans; Hydrocortisone; Infusions, Intravenous; Laryngeal Mucosa; Laryngitis; Male; Metoclopramide; Retreatment; Valacyclovir; Valine

Chronic laryngitis in patients with acquired immunodeficiency syndrome may be due to infections or tumors, such as Kaposi's sarcoma and non-Hodgkin's lymphoma. We present what we believe to be the first proven case of herpes simplex virus chronic laryngitis in a man positive for human immunodeficiency virus. Direct laryngoscopy showed leukoplakic lesions on both vocal cords. Biopsy of the lesions showed squamous epithelial cells with the characteristic features of herpes simplex virus, which was confirmed by immunohistochemical stains. We discuss the differential diagnosis of chronic laryngitis in a human immunodeficiency virus infection. Herpes simplex viral infection of the vocal cords should be considered in patients with acquired immunodeficiency syndrome presenting with chronic hoarseness and leukoplakic lesions on direct laryngoscopy, especially with no evidence of Kaposi's sarcoma, tumor, or cytomegaloviral or fungal infection elsewhere. Treatment should be acyclovir, except in the face of acyclovir resistance.

Topics: Acyclovir; AIDS-Related Opportunistic Infections; Biopsy; Chronic Disease; Diagnosis, Differential; Herpes Simplex; Humans; Laryngitis; Laryngoscopy; Male; Middle Aged; Vocal Cords