Pharyngolaryngeal Lesions Caused by Herpes Simplex Virus Infection

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  • Nakagawa Hideki
    Department of Otolaryngology, Seibo International Catholic Hospital
  • Nagasao Maki
    Department of Otolaryngology, Seibo International Catholic Hospital
  • Kohno Naoyuki
    Department of Otolaryngology, Kyorin University School of Medicine
  • Kusuyama Toshiyuki
    Tokyo Voice Center, International University of Health and Welfare
  • Fukuda Hiroyuki
    Tokyo Voice Center, International University of Health and Welfare
  • Ogawa Kaoru
    Department of Otolaryngology, Keio University School of Medicine

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Other Title
  • 単純ヘルペスウイルス感染による咽喉頭病変
  • 症例 単純ヘルペスウイルス感染による咽喉頭病変
  • ショウレイ タンジュン ヘルペスウイルス カンセン ニ ヨル インコウトウ ビョウヘン

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Abstract

The true incidence of herpes simplex virus (HSV) infections of the pharyngolarynx is unknown. The clinical files of 14 adult patients at Seibo International Catholic Hospital were reviewed. All presented with mucosal lesions in the pharyngolarynx and were diagnosed as HSV infection through detection of viral-specific antigens in the mucous membrane or measurement of titers of anti-HSV antibodies in the serum. Cases of herpetic labialis or herpetic gingivostomatitis, whose lesions were confined to the labia, gingiva or the oral cavity, were excluded. The patients ranged in age from 18 to 45 (mean 29.9) years, seven were male and seven were female. Ten were thought to be primary infection because of a lack of anti-HSV IgG titer at the first visit. High fever around 39°C was seen in all patients. All complained of severe sore throat and swallowing pain. The mucosal lesions were seen not only in the oropharynx including palate tonsils, but also in the epiglottis, the pyriform sinuses and the arytenoids. Laryngeal paresis and epiglottic edema were seen in some cases. Cheilitis or gingivitis, which are considered to be typical signs of HSV infection, were seen in fewer than half of the cases. HSV type 2 antigens were detected in 2 cases by direct immunofluorescence staining for virus antigens. Antiviral agents such as Acyclovir and Valacyclovir were used effectively in the treatment.

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