HERPES SIMPLEX - CLINICAL ASPECTS AND ELECTRON MICROSCOPIC FINDINGS

An unusual case of an infection with the herpesvirus hominis (HVH) has been presented. Vesicular and ulcerative lesions involved the vulva, the perineum, and the anus, including hemorrhoids. Gangrenous bullous lesions occurred on the skin of seven fingers. The typical clinical appearance and the absence of bacterial pathogens justify the diagnosis of herpetic whitlow. The clinical course was complicated by incapacitating constitutional symptoms and fever. The diagnoses of a HVH infection was confirmed by positive virus cultures, the electron microscopic demonstration of the HVH in biopsy specimens of an ulcerative lesion, and by a fourfold increase of the neutralizing antibody titer in the patient's serum. Three morphologically different stages of the HVH and phagocytosis of the virus by leukocytes has been observed and illustrated by electron micrographs. It has been discussed how the electron microscope can be used as a diagnostic method, how it can aid in clinicopathologic research concerning the mechanisms involved in virus infections, and how it could aid in the development of new modes of therapy. © 1969.