Coexisting HSV and HPV Infection in a Patient with Job's Syndrome

A 12 year-old boy and a known case of Job’s syndrome presented with a large conjunctival mass which represented coexistence of HPV and HSV infections.Case Report: The presence of HPV virus within these lesions was confirmed by biopsy and DNA analysis. The mass lesions did not respond to anti-HPV therapy with topical interferon-2b, oral cimetidine and oral acyclovir, but improved promptly with antiviral therapy with intravenous acyclovir administered for cutaneous herpetic lesions. HSV infection was diagnosed clinically by the typical extensive epithelial dendritic lesion over the conjunctival mass and its dramatic response to IV acyclovir. Based on our results and on the relevant literature we propose an immunological mechanism for this unique manifestation of coexisting herpes simplex virus and human papilloma virus infections in hyper-IgE syndrome.