Resumo

CASARIEGO ZULEMA, J.; BUTLER, T.  e  CABRINI, M.. Herpes virus 1-2 infection as a manifestation of the immune reconstitution syndrome: Actualization and case report of difficult diagnose. Av Odontoestomatol [online]. 2010, vol.26, n.6, pp.313-322. ISSN 2340-3152.

Frequently on Aids patients, oral lesions are difficult to diagnose. Our objective is to actualize the etiopathogenie of Herpes virus infection, especially on oral mucosa and to present an immunosupressed patient with atypical oral tonge´s lesions of Herpes virus. A case report. Male 39 years old, homosexual, with HZV, TBC and ETS history. CMV, B hepatitis and toxoplasmosis negative. Activated hepatospleenmegalia, peritoneum granulomatous fibrosis desease and mesentheric adenopathies. 12/ml CD4 and log 5.54 viral load. Instalation of Haart was succefull. After one month he returned with problems pronounce, excessive salivation, pain and exofitic lesions on his tonge, which offered a goffered, bumpy, ruffled and crimped surface with erosions, ulcers and papules covered by a yellowed pseudomembrana. Cultures of fungus, bacteria or parasiten were negative. Successive biopsies were analized by 5 pathologists who have discarded any malignancy or autoimmune disease. Similar diagnostics referred "chronic inflammatory reaction". A sixth expert, referred that HSV histological details and immunomarcation with HSV-I/HSV-II antiserum corresponded to nuclear and idioplasmatic positivity. Epifluorescence and electronic microscopic certificated diagnose. Acyclovir 4g/daily, four weeks was successful. Conclusion. Herpes virus infection on patients with severe immunosupression complicate clinicdiagnose, that's why it is convienent to exhaust auxiliary examinations.

Palavras-chave : HSV (herpes virus); TBC (tuberculosis); ETS (sexual trasmited disease); CMV (citomegalovirus); HARRT (antiretroviral therapy of high efficacy).

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