Herpes simplex in a liver transplant recipient

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

“…PCR for HSV was performed retrospectively on sera from several HSV hepatitis patients, including nontransplant recipients. It was positive in all those tested (30,31), suggesting it could be a useful, rapid test for this disease. A prominent clinical finding is disseminated intravascular coagulation concomitant with fever, abdominal pain and elevated transaminases.…”

“…The donor source was established by showing that the recipients seroconverted in the early posttransplant period and donor and recipient had identical strains of virus (28,29). These patients did not receive acyclovir prophylaxis and hepatitis continues to be reported in the current era in recipients who do not receive prophylaxis (30,31). PCR for HSV was performed retrospectively on sera from several HSV hepatitis patients, including nontransplant recipients.…”

“…The median time to onset of oral and genital lesions was 19 and 24 days postoperatively (16). All cases of primary HSV hepatitis and disseminated visceral disease transmitted by donor organs presented within 3 weeks of transplantation (26)(27)(28)(29)31). In a randomized, placebo-controlled trial of acyclovir in HSV seropositive renal transplant recipients (34), 14 of 21 placebo recipients developed culture positive lesions within 28 days posttransplant.…”

Fatal herpes simplex virus type 2 hepatitis in a heart transplant recipient: a case report and review of the literature

“…In another case series evaluating infections in 6 heart transplant recipients, 3 patients had HSV infection, 1 with HSV hepatitis, and the other 2 cases with only mucocutaneous involvement . A small case series described HSV hepatitis occurring in a liver transplant and a kidney transplant recipient, in addition to a heart transplant recipient who was infected with HSV‐2 from reactivation (Table ) .…”

HSV infection and immunosuppression

“…In their brief report, Campsen et al 1 remind us of the potential severity of necrotizing HSV hepatitis, which complicated live donor, right lobe liver transplant in a 57-year old Hepatitis C recipient. Terminal findings also included resistant pseudomonas intra-abdominal sepsis due to a partial bile duct disruption.…”