Herpes Simplex Hepatitis in Pregnancy

Kang, Audrey H.; Graves, Cornelia R.

doi:10.1097/00006254-199907000-00026

Cited by 83 publications

(11 citation statements)

References 25 publications

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“…13 After patients with immunosuppression, pregnant women are the largest group of adults with disseminated HSV infection; in one review, the mean gestational age at presentation was 31 weeks, and the case fatality rate was 39% for both mothers and neonates. 14 Other reviews have confirmed a high burden of HSV hepatitis among pregnant women 15,16 ; however, data on the incidence of primary HSV infection among pregnant women are limited. Recurrences of genital HSV infection increase in frequency during pregnancy, 17 although the clinical characteristics of recurrent genital HSV infection are similar in pregnant women and nonpregnant women.…”

Section: Pregnancy and Severity Of Infectionmentioning

confidence: 99%

Pregnancy and Infection

2014

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Section: Pregnancy and Severity Of Infectionmentioning

confidence: 99%

Pregnancy and Infection

2014

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“…Only 30–50% show characteristic herpetic skin lesions [3–7]. Laboratory investigations often show leucopenia, thrombocytopenia, and coagulopathy [3–6, 8–10]. Renal failure is not uncommon in these patients [5, 11–14], and it has been shown to occur in up to 65% of patients with HSV-related ALF [3].…”

Section: Discussionmentioning

confidence: 99%

Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure

Poley

Snowdon

Howes

2011

Case Reports in Critical Care

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Objective. To present a case of a healthy 41-year-old female who developed fulminant hepatic failure leading to death. The cause of hepatic failure identified on postmortem exam was herpes simplex virus hepatitis. Design. Observation of a single patient. Setting. Intensive care unit of a tertiary care university teaching hospital in Canada. Patient. 41-year-old previously healthy female presenting with a nonspecific viral illness and systemic inflammatory response syndrome. Intervention. The patient was treated with intravenous fluids and broad-spectrum antibiotics. On the second day of admission, she was found to have elevated transaminases, and, over 48 hours, she progressed to fulminant liver failure with disseminated intravascular coagulopathy, refractory lactic acidosis, and shock. She progressed to respiratory failure requiring intubation and mechanical ventilation. She was started on N-acetylcysteine, a bicarbonate infusion, hemodialysis, and multiple vasopressors and inotropes. Measurements and Main Results. Despite treatment, the patient died roughly 70 hours after her initial presentation to hospital. Her postmortem liver biopsy revealed herpes simplex virus hepatitis as her cause of death. Conclusions. Herpes simplex virus must be considered in all patients presenting with liver failure of unknown cause. If suspected, prompt treatment with acyclovir should be initiated.

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“…Second, the maternal-placental interface appears to have fairly effective mechanisms to block the spread of HSV. Interestingly, even in cases with severe or disseminated maternal HSV infection during pregnancy, the fetus is often spared [84]. HSV DNA can be detected by PCR in a surprising proportion of placentas (roughly 10%) [85, 86].…”

Section: Epidemiology and Clinical Manifestations Of Neonatal Hsv mentioning

confidence: 99%

The Immunologic Basis for Severe Neonatal Herpes Disease and Potential Strategies for Therapeutic Intervention

Gantt

Muller

2013

Clinical and Developmental Immunology

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Herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2) infect a large proportion of the world's population. Infection is life-long and can cause periodic mucocutaneous symptoms, but it only rarely causes life-threatening disease among immunocompetent children and adults. However, when HSV infection occurs during the neonatal period, viral replication is poorly controlled and a large proportion of infants die or develop disability even with optimal antiviral therapy. Increasingly, specific differences are being elucidated between the immune system of newborns and those of older children and adults, which predispose to severe infections and reflect the transition from fetal to postnatal life. Studies in healthy individuals of different ages, individuals with primary or acquired immunodeficiencies, and animal models have contributed to our understanding of the mechanisms that control HSV infection and how these may be impaired during the neonatal period. This paper outlines our current understanding of innate and adaptive immunity to HSV infection, immunologic differences in early infancy that may account for the manifestations of neonatal HSV infection, and the potential of interventions to augment neonatal immune protection against HSV disease.

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Herpes Simplex Hepatitis in Pregnancy

Cited by 83 publications

References 25 publications

Pregnancy and Infection

Pregnancy and Infection

Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure

The Immunologic Basis for Severe Neonatal Herpes Disease and Potential Strategies for Therapeutic Intervention

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