Herpes Simplex Virus Type 1 Hepatitis in an Immunocompetent Female After Laparoscopic Cholecystectomy

Abstract

We present a rare case of a healthy, non-pregnant, middle-aged and immunocompetent woman who underwent laparoscopic cholecystectomy for acute cholecystitis with a post-operative course complicated by herpes simplex virus type 1 (HSV-1) hepatitis secondary to post-surgical inflammation. Her initial post-operative course was complicated by intermittent fevers, leukocytosis, jaundice, elevated transaminases, and right upper quadrant abdominal pain, and she was subsequently placed on broad-spectrum antibiotics with no improvement. During her hospital course, the patient developed herpes labialis, and HSV-1 hepatitis was confirmed by serology and HSV-1 polymerase chain reaction (PCR), in lieu of a liver biopsy. After this was discovered, the patient was placed on valacyclovir and had a successful response. The importance of this case is to emphasize the possibility of herpes simplex virus (HSV) hepatitis as a post-operative complication and the benefit of early empiric antiviral treatment.

Herpes simplex virus hepatitis in a renal transplant recipient seronegative pre-transplant

“…Cases are predominantly reported in immunocompromised solid organ and stem cell transplant recipients, and chronic diseases requiring immunosuppressive agents (1)(2)(3)(4)(5)(6). There have been few cases reported during pregnancy and in immunocompetent hosts (7)(8)(9)(10)(11)(12). We report a case of HSV hepatitis in a kidney transplant recipient.…”