Necrotic Herpes Simplex Virus Infection of the Nose and Orbit

Stephen C. Dryden, James Fleming

Research output: Contribution to journalArticle

Abstract

This is the first reported case of necrotizing nasal and sinus herpes infection with orbital involvement. A 94-year-old male with a past medical history of hypertension, congestive heart failure, and chronic kidney disease presented with necrotic nasal cellulitis and a red left eye with blurry vision. Onset was 2 weeks prior with an upper lip fever blister. He was admitted to medicine and started on antimicrobials. Maxillofacial computed tomography scan revealed pansinusitis with involvement of bilateral medial orbital walls. Initial nasal biopsy was negative. Repeat biopsy was positive for herpes simplex virus 1. His nose was debrided with full-thickness skin grafting. While there are reports of necrotizing herpes simplex, none were to the extent of our patient nor raised suspicion for invasive fungal sinusitis. Differentiating is important as this patient made a full recovery in comparison to patients with mucormycosis where mortality is often as high as 80%.

Original languageEnglish (US)
Pages (from-to)e21-e22
JournalOphthalmic Plastic and Reconstructive Surgery
Volume35
Issue number1
DOIs
StatePublished - Jan 1 2019

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Orbit
Virus Diseases
Simplexvirus
Nose
Herpes Labialis
Mucormycosis
Biopsy
Skin Transplantation
Herpes Simplex
Cellulitis
Paranasal Sinuses
Sinusitis
Human Herpesvirus 1
Lip
Chronic Renal Insufficiency
Heart Failure
Tomography
Medicine
Hypertension
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

Cite this

Necrotic Herpes Simplex Virus Infection of the Nose and Orbit. / Dryden, Stephen C.; Fleming, James.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 35, No. 1, 01.01.2019, p. e21-e22.

Research output: Contribution to journalArticle

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