Frontiers in Medicine (Nov 2022)

Case report: Disseminated herpes simplex virus 1 infection and hemophagocytic lymphohistiocytosis after immunomodulatory therapy in a patient with coronavirus disease 2019

  • Elvio Mazzotta,
  • Juan Fiorda Diaz,
  • Marco Echeverria-Villalobos,
  • Gregory Eisinger,
  • Sarah Sprauer,
  • Arindam Singha,
  • Michael R. Lyaker

DOI
https://doi.org/10.3389/fmed.2022.1053012
Journal volume & issue
Vol. 9

Abstract

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Corticosteroids and immunomodulatory therapies are widely used to treat patients with severe coronavirus disease 2019 (COVID-19). Janus kinase (JAK) inhibitors such as tofacitinib have been recently studied as adjuvants in the treatment of COVID-19. Although immunomodulatory therapies may be linked to decreased mortality rates in the acute phase, subsequent severe infectious complications may result from them. We describe a case of a multiorgan system failure secondary to disseminated primary herpes simplex virus 1 (HSV-1) infection and hemophagocytic lymphohistiocytosis (HLH) following treatment with tofacitinib and high-dose dexamethasone therapy for severe COVID-19. Early diagnosis and treatment of these life-threatening conditions may have a significant impact on COVID-19 patients’ outcomes.

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