Case Report: Sequential mNGS captures fatal HSV-1 reactivation after intestinal obstruction-associated ARDS in a 91-year-old
Abstract
Herpes simplex virus type 1 (HSV-1) is a ubiquitous pathogen. Nevertheless, disseminated HSV-1 infection with confirmed viremia and fatal acute respiratory distress syndrome (ARDS) following intestinal obstruction in very old individuals is exceedingly rare. Here we report a 91-year-old patient with previously intact immunity who developed ARDS after incomplete intestinal obstruction, followed by HSV-1 reactivation. Although routine microbiological tests remained negative, five consecutive metagenomic next-generation sequencing (mNGS) assays dynamically tracked the evolving pathogens throughout the disease course. Despite broad-spectrum antibiotics, antifungals, antivirals, corticosteroids, IVIG, and mechanical ventilation, the patient's refractory hypoxemia remained uncorrected, leading to multiple organ dysfunction and death. This case highlights a rare clinical scenario and provides valuable insights for the diagnosis and management of critically ill elderly patients, offering a comprehensive, longitudinal perspective on the clinical application of mNGS.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Structural and topological analysis of thiosemicarbazone-based metal complexes: computational and experimental study of bacterial biofilm inhibition and antioxidant activity
- Toward better cures for Mycobacterium abscessus lung disease
- Challenges for global antibiotic regimen planning and establishing antimicrobial resistance targets: implications for the WHO Essential Medicines List and AWaRe antibiotic book dosing
- Design, Synthesis and In vitro Antitubercular Effect of New Chalcone Derivatives Coupled with 1,2,3‐Triazoles: A Computational Docking Techniques
- Upregulation of pmrA, pmrB, pmrC, phoQ, phoP, and arnT genes contributing to resistance to colistin in superbug Klebsiella pneumoniae isolates from human clinical samples in Tehran, Iran
- Whole-genome sequencing of clinical isolates of Citrobacter Europaeus in China carrying blaOXA−48 and blaNDM−1
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.