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

Review

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

Yan Zhang1*, Ming Hu2*, Dong Wei3, Hui Zhang4, Bao Chu2, Hao-Ming Xu5, Tao Wang6✉

1. Department of Dermatology, the 4th Affiliated Hospital of HeBei Medical University, No.12 JianKang Road, ShiJiaZhuang 050011, P.R. China.
2. Department of Neurology, HeBei Provincial General Hospital, No.348 West HePing Boulevard, ShiJiaZhuang 050051, P.R. China.
3. Department of Urology, HeBei Provincial General Hospital, No.348 West HePing Boulevard, ShiJiaZhuang 050051, P.R. China.
4. Department of Medical Imaging, HeBei Provincial General Hospital, No.348 West HePing Boulevard, ShiJiaZhuang 050051, P.R. China.
5. Department of Respiratory Diseases, HeBei Provincial General Hospital, No.348 West HePing Boulevard, ShiJiaZhuang 050051, P.R. China.
6. Department of Science and Education, HeBei Provincial General Hospital, No.348 West HePing Boulevard, ShiJiaZhuang 050051, P.R. China.
*Equal contributions as co-first authors.

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Citation:
Zhang Y, Hu M, Wei D, Zhang H, Chu B, Xu HM, Wang T. 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; 17(6):745-750. doi:10.7150/ijms.41952. Available from http://www.medsci.org/v17p0745.htm

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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: kidney diseases, immunosuppression, opportunistic infection, herpes zoster, suid herpesvirus encephalitis