Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report
Abstract Background Eczema herpeticum (EH) is a severe skin complication caused by human simplex virus (HSV) infection concomitant with immune dysfunction and dermatological conditions, mainly atopic dermatitis. We present the first case of EH subsequent to sepsis-related immunological suppression i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-021-06924-9 |
| _version_ | 1819177311788859392 |
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| author | Kiichiro Furuya Yuki Takemoto Hiroki Kurahashi Harue Hayashida Sho Fujiwara Saya Yamashita Yangsil Chang Hiroaki Tsubouchi Kayoko Shikado Kazuhide Ogita |
| author_facet | Kiichiro Furuya Yuki Takemoto Hiroki Kurahashi Harue Hayashida Sho Fujiwara Saya Yamashita Yangsil Chang Hiroaki Tsubouchi Kayoko Shikado Kazuhide Ogita |
| author_sort | Kiichiro Furuya |
| collection | DOAJ |
| description | Abstract Background Eczema herpeticum (EH) is a severe skin complication caused by human simplex virus (HSV) infection concomitant with immune dysfunction and dermatological conditions, mainly atopic dermatitis. We present the first case of EH subsequent to sepsis-related immunological suppression in pregnancy. Case presentation Septic shock developed in a 30-year-old primiparous woman at 14 weeks of pregnancy during admission for hyperemesis gravidarum. Although her life-threatening status due to sepsis improved by prompt treatment, on day 3 of treatment in the intensive care unit, blisters suddenly erupted on her face and neck and spread over her body. EH was diagnosed according to HSV type-1 antigen positivity and a past medical history of EH and atopic dermatitis. Antiviral agents were administered immediately, with positive results. Her general condition improved quickly, without central nervous system defects. This is the first report of EH following septic shock in early pregnancy. At present, we speculate that EH develops as a complication due to immunological changes in the late phase of sepsis because sepsis is mainly characterized by both an inflammatory state in the acute phase and an immunosuppressive state in the late phase. Pregnancy can also contribute to its pathogenesis, as it causes an immunosuppressive state. Mortality due to EH is relatively high; in this case, a history of EH and atopic dermatitis contributed to the initiation of prompt medical interventions for the former, with improvement in the patient’s severe condition. The combination of immunological changes in sepsis and pregnancy can cause HSV reactivation, resulting in EH recurrence. Conclusions In conclusion, if dermatological symptoms develop in a pregnant woman with a history of EH and/or atopic dermatitis treated for sepsis, EH should be suspected based not only on clinical features but also on immunological changes along with sepsis, and prompt medical interventions should be initiated. |
| first_indexed | 2024-12-22T21:24:39Z |
| format | Article |
| id | doaj.art-451c3ce6cdf047fb99d36aea320bfe88 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-22T21:24:39Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-451c3ce6cdf047fb99d36aea320bfe882022-12-21T18:12:05ZengBMCBMC Infectious Diseases1471-23342021-12-012111410.1186/s12879-021-06924-9Eczema herpeticum subsequent to septic shock in early pregnancy: a first case reportKiichiro Furuya0Yuki Takemoto1Hiroki Kurahashi2Harue Hayashida3Sho Fujiwara4Saya Yamashita5Yangsil Chang6Hiroaki Tsubouchi7Kayoko Shikado8Kazuhide Ogita9Department of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreDepartment of Obstetrics and Gynaecology, Rinku General Medical CentreAbstract Background Eczema herpeticum (EH) is a severe skin complication caused by human simplex virus (HSV) infection concomitant with immune dysfunction and dermatological conditions, mainly atopic dermatitis. We present the first case of EH subsequent to sepsis-related immunological suppression in pregnancy. Case presentation Septic shock developed in a 30-year-old primiparous woman at 14 weeks of pregnancy during admission for hyperemesis gravidarum. Although her life-threatening status due to sepsis improved by prompt treatment, on day 3 of treatment in the intensive care unit, blisters suddenly erupted on her face and neck and spread over her body. EH was diagnosed according to HSV type-1 antigen positivity and a past medical history of EH and atopic dermatitis. Antiviral agents were administered immediately, with positive results. Her general condition improved quickly, without central nervous system defects. This is the first report of EH following septic shock in early pregnancy. At present, we speculate that EH develops as a complication due to immunological changes in the late phase of sepsis because sepsis is mainly characterized by both an inflammatory state in the acute phase and an immunosuppressive state in the late phase. Pregnancy can also contribute to its pathogenesis, as it causes an immunosuppressive state. Mortality due to EH is relatively high; in this case, a history of EH and atopic dermatitis contributed to the initiation of prompt medical interventions for the former, with improvement in the patient’s severe condition. The combination of immunological changes in sepsis and pregnancy can cause HSV reactivation, resulting in EH recurrence. Conclusions In conclusion, if dermatological symptoms develop in a pregnant woman with a history of EH and/or atopic dermatitis treated for sepsis, EH should be suspected based not only on clinical features but also on immunological changes along with sepsis, and prompt medical interventions should be initiated.https://doi.org/10.1186/s12879-021-06924-9Eczema herpeticumAtopic dermatitisPregnancySepsisImmunosuppressionCase report |
| spellingShingle | Kiichiro Furuya Yuki Takemoto Hiroki Kurahashi Harue Hayashida Sho Fujiwara Saya Yamashita Yangsil Chang Hiroaki Tsubouchi Kayoko Shikado Kazuhide Ogita Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report BMC Infectious Diseases Eczema herpeticum Atopic dermatitis Pregnancy Sepsis Immunosuppression Case report |
| title | Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report |
| title_full | Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report |
| title_fullStr | Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report |
| title_full_unstemmed | Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report |
| title_short | Eczema herpeticum subsequent to septic shock in early pregnancy: a first case report |
| title_sort | eczema herpeticum subsequent to septic shock in early pregnancy a first case report |
| topic | Eczema herpeticum Atopic dermatitis Pregnancy Sepsis Immunosuppression Case report |
| url | https://doi.org/10.1186/s12879-021-06924-9 |
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