Viral pneumonia: coinfection of cytomegalovirus and herpes simplex virus.

she had been treated with various chemotherapeutic regimens with partial remission. On admission, she had pigmented skin lesions, cervical and axillary lymphadenopathy, and genital ulcers. Laboratory data included erythrocyte sedimentation rate 118 mm/h, C-reactive protein 14.2 mg/dl, hemoglobin 7.4 g/dl, leukocyte count 2,300/mm with 42% neutrophils and 28% lymphocytes, platelet count 161,000/mm, lactic dehydrogenase 705 IU/l, and soluble IL-2 receptor 20,500 U/ml. Serology for HTLV-I antibody was negative. She was treated with antibiotics and high-dose methylprednisolone. However, her clinical condition gradually worsened with severe hepatic dysfunction, hypoxemia, and disseminated intravascular coagulation, causing death 1 month after admission. Chest radiograph obtained 2 days before death demonstrated patchy and reticular infiltrates. Postmortem examination revealed residual lymphoma cells in several organs. The liver showed a typical feature of herpes simplex virus (HSV) hepatitis (Pathol Int 51: 288-292, 2001). The lungs were coinfected with cytomegalovirus