From Severe Herpes Zoster to Rare Suid Herpesvirus Encephalitis: A New Twist of the Varicellovirus Genus Infection in Patients with Kidney Diseases

Int J Med Sci. 2020 Mar 5;17(6):745-750. doi: 10.7150/ijms.41952. eCollection 2020.

Abstract

Both the herpes zoster virus and suid herpesvirus type 1 (SuHV-1) belong to the Varicellovirus genus of the α-herpesviridae subfamily. They may cause opportunistic infections especially in patients with kidney diseases, varying from latent illness to overt lethality. Under these circumstances, impaired renal function is both the culprit for and victim of the infection. However, fulminant eruption of severe skin herpes zoster in lupus nephritis (LN) patients under prolonged immunosuppressive therapy is rare and even more rarely seen is the SuHV-1 encephalitis in human. Facing the evolution of these rare infections, we hence chose to review the clinical pathogenicity of these two viruses which were cognate in origin but distinct in virulence. As such, we began with the first of the two above viral diseases and proceeded with peculiar renal involvement, unique clinical symptoms and pertinent lethal risk. Of importance, LN was used to exemplify the reciprocally detrimental interactions between impaired renal function and suppressed immune response. Then in a manner similar to the gradient overlay, SuHV-1 encephalitis was discussed focusing on its neurotropic features, specific MRI findings and exclusive test of high throughput sequencing. Our report highlighted novel presentations of the Varicellovirus genus infection by providing a productive multidisciplinary communication with pointed disclosure of the renal involvement. It may therefore be of great medical relevance and educational value for clinicians, especially the unseasoned ones, to foresee and manage similar cases in susceptible patients.

Keywords: herpes zoster; immunosuppression; kidney diseases; opportunistic infection; suid herpesvirus encephalitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Herpes Zoster / complications
  • Herpes Zoster / epidemiology*
  • Herpes Zoster / genetics
  • Herpes Zoster / virology
  • Herpesviridae Infections / complications
  • Herpesviridae Infections / epidemiology
  • Herpesviridae Infections / genetics
  • Herpesviridae Infections / virology
  • Herpesvirus 1, Suid / pathogenicity*
  • Humans
  • Infectious Encephalitis / complications
  • Infectious Encephalitis / epidemiology*
  • Infectious Encephalitis / genetics
  • Infectious Encephalitis / virology
  • Kidney Diseases / complications
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / genetics
  • Kidney Diseases / virology
  • Lupus Nephritis / complications
  • Lupus Nephritis / epidemiology
  • Lupus Nephritis / genetics
  • Lupus Nephritis / virology
  • Opportunistic Infections / complications
  • Opportunistic Infections / epidemiology
  • Opportunistic Infections / genetics
  • Opportunistic Infections / virology
  • Swine / virology
  • Varicellovirus / pathogenicity