PMC6022271_01
(a) Section from the ulcerated colonic mucosa with deep fissuring ulcer. Viral cytopathic changes are noted. (b, c) Giant cells within ulcer with characteristic intranuclear Cowdry type A inclusions of HSV-1 and HSV-2. Black arrows point to individual giant cells with Cowdry type A inclusions. (d) Immunohistochemistry study for HSV-2 antibody highlighted by the brown nuclear staining.
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The surgical biopsy from subtotal colectomy revealed extensive diffuse mucosal inflammation, acute ulceration, and mucosal and transmural ischemic changes from the ileum to the distal colon (Figure 1(a)). The ulcerated area exhibited granulation tissue that contained cells that diffusely exhibited intranuclear inclusions, morphologically and immunohistochemically consistent with herpes simplex virus (HSV-1 and HSV-2) (Figures 1(b)-1(d)).