López-Amado M, Yebra-Pimentel M T, García-Sarandeses A
Department of Otolaryngology, Hospital Juan Canalejo, Le Coruña, Spain.
Head Neck. 1996 Sep-Oct;18(5):455-7; discussion 457-8. doi: 10.1002/(SICI)1097-0347(199609/10)18:5<455::AID-HED9>3.0.CO;2-4.
Cytomegalovirus (CMV) infection is a common opportunistic pathogen in transplant recipients; however, cytomegaloviral laryngitis is extremely rare.
We present a case of disseminated CMV infection and ulcerating necrotizing laryngitis situated in the subglottis of an immunocompromised patient with a renal and cardiac transplant. The patient was initially seen with discomfort in the throat.
Physical examination of the head and neck, fiberoptic laryngoscopy, and CT scan of the larynx were normal. Histopathology of a laryngeal ulcer in the subglottic region showed intranuclear and intracytoplasmic bodies. Immunoperoxidase stain and in situ hybridization studies were positive for CMV.
In immunosuppressed patients with persistent throat symptoms, the systematic exploration of larynx and bronchus is necessary to rule out the presence of opportunistic infections.
巨细胞病毒(CMV)感染是移植受者中常见的机会性病原体;然而,巨细胞病毒性喉炎极为罕见。
我们报告一例免疫功能低下的肾和心脏移植患者发生播散性CMV感染及位于声门下的溃疡性坏死性喉炎的病例。该患者最初因咽喉不适就诊。
头颈部体格检查、纤维喉镜检查及喉部CT扫描均正常。声门下区域喉部溃疡的组织病理学检查显示核内及胞浆内包涵体。免疫过氧化物酶染色及原位杂交研究CMV呈阳性。
对于有持续咽喉症状的免疫抑制患者,有必要对喉和支气管进行系统检查以排除机会性感染的存在。