In patients receiving potent steroids, which viral infection is most commonly of concern?

In patients receiving potent steroids, which viral infection is most commonly of concern?

• A. Herpes Simplex Virus
• B. Varicella Zoster Virus
• C. Cytomegalovirus
• D. Epstein-Barr Virus

Answer: (A)

Potent steroids weaken cell-mediated immunity, which normally keeps latent herpesviruses in check. When this surveillance drops, herpesviruses can reactivate, and among them herpes simplex virus is a common reactivation causing cold sores or related mucocutaneous lesions. Varicella zoster virus can also reactivate (shingles), but herpes simplex reactivation is typically the most frequently encountered issue in patients on high-dose steroids. Cytomegalovirus and Epstein-Barr virus reactivations tend to occur in more severely immunocompromised settings or specific clinical contexts, so they are not the usual first concern with standard potent steroid therapy.

Potent steroids weaken cell-mediated immunity, which normally keeps latent herpesviruses in check. When this surveillance drops, herpesviruses can reactivate, and among them herpes simplex virus is a common reactivation causing cold sores or related mucocutaneous lesions. Varicella zoster virus can also reactivate (shingles), but herpes simplex reactivation is typically the most frequently encountered issue in patients on high-dose steroids. Cytomegalovirus and Epstein-Barr virus reactivations tend to occur in more severely immunocompromised settings or specific clinical contexts, so they are not the usual first concern with standard potent steroid therapy.