Successful Acyclovir Treatment of Herpes Simplex Type 2 Hepatitis in a Patient with Systemic Lupus Erythematosus: A Case Report and Meta Analysis

Chung, Andrew B.; Fas, Norberto

doi:10.1097/00000441-199812000-00010

Cited by 17 publications

(4 citation statements)

References 16 publications

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“…Our case is of particular interest given the rarity of viral hepatitis secondary to disseminated HSV-2 in an immunocompetent host. Viral hepatitis accounts for only 1–2% of all viral causes of acute liver failure [ 6 – 10 ]. Risk factors for disseminated disease include immunodeficiency, immunocompromised state, post-transplantation, and pregnancy (primarily in the third trimester); however, up to 25% of cases occur in immunocompetent patients [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Herpes Simplex Virus-2 (HSV-2) as a Cause of Viral Hepatitis in an Immunocompetent Host

et al. 2021

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Patient: Male, 57-year-old Final Diagnosis: Hepatitis • herpes Symptoms: Fever Medication: — Clinical Procedure: — Specialty: General and Internal Medicine Objective: Challenging differential diagnosis Background: Herpes simplex virus-2 (HSV-2) affects nearly 1 in 5 adults in the United States. Complications such as viral hepatitis and dissemination are rare in immunocompetent hosts. In this report, we describe a case of viral hepatitis secondary to disseminated HSV-2 in an immunocompetent patient with recurrent fevers and elevated aminotransferases. Case Report: A 57-year-old man with a history of type 2 diabetes and hypertension was admitted with a right index finger lesion concerning for an abscess. He underwent successful incision and drainage and was started on ampicillin-sulbactam. On Day 2 of hospitalization, he developed recurrent fevers and elevated aminotransferases and inflammatory markers. An extensive infectious, rheumatologic, and malignancy workup were pursued without immediate findings. Imaging demonstrated cirrhotic morphology of the liver and splenomegaly, but lab markers were intact for liver synthetic function. On Day 7 of hospitalization, fever frequency decreased, and HSV-2 titers resulted, with positive IgM and negative IgG. He subsequently developed erythematous, raised lesions in multiple dermatomes. Nucleic acid amplification testing of biopsied lesions was positive for HSV-2, confirming viral hepatitis secondary to disseminated HSV-2. He was started on intravenous acyclovir and discharged on valacyclovir following improvement in symptoms. Conclusions: We report a case of viral hepatitis secondary to disseminated HSV-2 in an immunocompetent host. Up to 25% of cases occur in immunocompetent hosts and many patients do not develop characteristic skin lesions. Early diagnosis and treatment of viral hepatitis secondary to disseminated HSV remains vital to minimize morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Disseminated Herpes Simplex Virus-2 (HSV-2) as a Cause of Viral Hepatitis in an Immunocompetent Host

et al. 2021

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“…The association of short-course and long-course steroid therapy with HSV FH has been described in a few cases. 16,19,26,36,44 Some authors have proposed the hypothesis that the association of corticosteroids with primary infection by HSV could promote amplification of viral load, overwhelming the immune system and promoting an invasive infection. 26 HSV bronchopneumonitis has been related to prolonged mechanical ventilation in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Herpes Simplex Hepatitis Following a Short Course of Corticotherapy in a Child

Barreira

Bousso

Shieh

et al. 2009

Clin Pediatr (Phila)

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“…17 Several authors emphasize the importance of the early diagnosis and treatment of herpes simplex hepatitis. 18,19 Yet early diagnosis can be difficult. A recent literature review showed that only 27% of patients had oral lesions; 31% had genital lesions; and only 4% (two patients) presented with both types of lesions, as in our patient.…”

Section: Discussionmentioning

confidence: 99%

Herpes simplex virus hepatitis 4 years after liver transplantation

Bissig¹,

Zimmermann²,

Bernasch³

et al. 2003

Journal of Gastroenterology

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If not promptly recognized and treated, herpes simplex virus (HSV) hepatitis is associated with a high mortality. A patient transplanted for primary sclerosing cholangitis required, 4 years later, a colectomy for a steroid-resistant flare of ulcerative colitis. He subsequently developed fever, with genital and oral ulcerations. He was hospitalized for diabetic decompensation with massive elevation of serum aminotransferases. Examination revealed vesicles on the hands. Liver biopsy showed Cowdry type B inclusions. Therapy with acyclovir was immediately initiated and the patient recovered. This case illustrates the diagnostic importance of mucocutaneous lesions in the assessment of complications after liver transplantation.

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Successful Acyclovir Treatment of Herpes Simplex Type 2 Hepatitis in a Patient with Systemic Lupus Erythematosus: A Case Report and Meta Analysis

Cited by 17 publications

References 16 publications

Disseminated Herpes Simplex Virus-2 (HSV-2) as a Cause of Viral Hepatitis in an Immunocompetent Host

Disseminated Herpes Simplex Virus-2 (HSV-2) as a Cause of Viral Hepatitis in an Immunocompetent Host

Fulminant Herpes Simplex Hepatitis Following a Short Course of Corticotherapy in a Child

Herpes simplex virus hepatitis 4 years after liver transplantation

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