Article Text

Severe herpes simplex virus pneumonia in an elderly, immunocompetent patient
  1. Toru Ishihara,
  2. Hidetaka Yanagi,
  3. Hideki Ozawa,
  4. Atsushi Takagi
  1. Division of General Internal Medicine, Tokai University School of Medicine, Isehara, kanagawa, Japan
  1. Correspondence to Dr Toru Ishihara, it735130{at}


Although not common, herpes simplex virus (HSV) pneumonia can occur in immunocompromised patients. However, HSV pneumonia in immunocompetent hosts is very rare. The authors encountered a very rare case of severe HSV pneumonia in an immunocompetent host. The patient was an 85-year-old Japanese woman who presented with severe intractable pneumonia refractory to empirical antimicrobial therapy. Furthermore, the causative microorganisms remained unknown. Therefore, cytological examination of bronchoalveolar lavage fluid and protected brush biopsy of the lower respiratory tract were performed, which indicated herpes virus-infected cells with nuclear inclusions; PCR assay was positive for HSV DNA. Accordingly, the patient was diagnosed with HSV pneumonia. Her respiratory condition improved immediately after initiation of acyclovir monotherapy. In selected cases of intractable pneumonia refractory to standard antimicrobial therapy, the possibility of HSV pneumonia should be pursued.

  • primary care
  • general practice / family medicine
  • pneumonia (infectious disease)
  • adult intensive care
  • pneumonia (respiratory medicine)

Statistics from


  • Contributors TI prepared the manuscript and HY gave precise advice and edited the manuscript. HO and AT supervised. All authors have read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.