Pneumologie 2025; 79(S 01): S97-S98
DOI: 10.1055/s-0045-1804756
Abstracts
D1 – Infektiologie und Tuberkulose

Herpes simplex virus diagnosis in the bronchoalveolar lavage of immunocompromised patients- results of a prospective study

Authors

  • T Zouvani

    1   Clinic of Pneumology, Medical Center – University of Freiburg; Pneumologie

  • M Karakioulaki

    2   Clinic of Pneumology, Medical Center – University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany

  • K Jahn

    3   University Hospital Basel; Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital; Clinic of Pulmonary Medicine and Respiratory Cell Research

  • L Grize

    4   Clinic of Pneumology, Medical Center – University of Freiburg

  • E Papakonstantinou

    5   Department of Pneumology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.; Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital, 4031 Basel, Switzerland.

  • H Hengel

    6   Institute for Virology; University Medical Center Freiburg

  • K leuzinger

    7   University Hospital Basel; Clinical Virology, Laboratory Medicine, University Hospital Basel

  • H Hirsch

    8   University Hospital Basel; Clinical Virology, Laboratory Medicine, University Hospital Basel; Infectious Diseases & Hospital Epidemiology, Department of Acute Medicine, Clinical Virology, Laboratory Medicine, Transplantation & Clinical Virology, Department Biomedicine

  • D Stolz

    9   Universitätsklinikum Freiburg; Klinik für Pneumologie, Department Innere Medizin, Medizinische Fakultät, Albert Ludwigs Universität, Freiburg, Deutschland; Clinic of Respiratory Medicine and Pulmonary Cell Research
Further Information
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Human herpes simplex virus (HSV) infections are prevalent and pose significant risk for immunocompromised (IC) individuals. This study aimed to evaluate the impact of lower respiratory infections (LRTIs) with HSV diagnosed via PCR in bronchoalveolar lavage fluid (BALF) in immunocompromised patients.

2,666 visits of 1,301 patients undergoing bronchoscopy for suspicion of LRTI were included in this study. Of these, 119 cases tested positive for HSV1 and/or HSV2 in BAL (haematological disease (n=43), solid organ transplantation (n=24) and other causes (n=52)). The primary outcome assessed was predefined modifications in patient management with follow-up conducted for up to 30 days.

BAL findings prompted therapeutic adjustments in 69.19% (n=82) of HSV-infected cases. Among the 119 HSV-positive cases, 63.87% (n=76) demonstrated coinfections with viral, fungal, or bacterial pathogens. Mixed infections were associate to higher neutrophil counts in BALF (42% CI 7.5-84-5% vs. 9% CI 2-59.5%). Unadjusted 30-day mortality rates were nummerically higher in those with positive HSV PCR in BALF (9.4% vs 5.7%, p=0.0961).

Respiratory infections with HSV are in the majority of cases associated with coinfection with bacterial, viral or fungal pathogens. Fiberoptic bronchoscopy, including BAL, emerges as a valuable tool facilitating treatment modifications in immunocompromised patients with LRTIs associated with HSV.



Publication History

Article published online:
18 March 2025

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