Facial Herpes Simplex Virus Type 1 Infection in a Patient with Multiple Sclerosis on Fingolimod

Racosta Juan Manuel¹, McEwan Lynn¹, Kremenchutzky Marcelo Carlos¹ and Morrow Sarah Anne^1,

¹University of Western Ontario, London, Ontario

Cite this paper:
Racosta Juan Manuel, McEwan Lynn, Kremenchutzky Marcelo Carlos and Morrow Sarah Anne. Facial Herpes Simplex Virus Type 1 Infection in a Patient with Multiple Sclerosis on Fingolimod. American Journal of Medical Case Reports. 2015; 3(5):144-145. doi: 10.12691/ajmcr-3-5-7

Abstract

Fingolimod is an oral disease-modifying therapy for relapsing multiple sclerosis widely used in Canada as a second-line therapy. Fingolimod increases the risk of infections given its dose-dependent reduction of peripheral lymphocytes, due to the reversible sequestration in lymphoid tissues. We present a case of disseminated facial Herpes Simplex Virus type I infection in a patient using fingolimod, with an atypical distribution of the eruption, likely due to the concomitant exposure to sunlight and application of sunscreen. This case report provides insight about a novel mechanism of disseminationof Herpes Simplex Virus type I, which generally enters damaged epithelium or mucosal surfaces secondary to abrasions or trauma. Since Herpes Simplex Virus type I infection tends to disseminate and is accompanied by visceral involvement in immunosuppressed patients, close surveillance of viral infections and the prompt administration of full-dose antiviral therapy in this population is advised.

Keywords:
multiple sclerosis fingolimod; herpes simplex infection adverse effect

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