Herpes Simplex Virus Hepatitis in an Immunocompetent Host Resembling Hepatic Pyogenic Abscesses

Dhiman RK, Chawla YK. Although most women with AFLP or HELLP improve with prompt delivery, some women require emergency liver transplantation. Fulminant, acyclovir-resistant, herpes simplex virus type 2 hepatitis in an immunocompetent woman. 1994;171:1154–8. PMID 19208917. We also considered CMV lymphadenitis in the differential diagnosis. Evolutionary origins of hepatitis A virus in small mammals”.

The factors that determine the development of chronic infection with HBV have not been fully identified. In addition, several of the patients were treated with high dose steroids in an effort to reduce the host immune response which is frequently recommended in patients with infectious mononucleosis who have marked adenopathy or splenomegaly. Swelling of the glands in your groin. The outcome of HBV infection depends on immunological factors and possibly in part on the characteristics of the virus. Seroprevalence estimates for HCV (2.3%), HBV (3.1%), and HSV-2 (22.3%) in Puerto Rico are roughly in agreement with estimates obtained in the US population aged 20-59 years, where age-adjusted prevalence was 2.4% for HCV (1.6% in the most recent NHANES), 5.6% for HBV, and 25.1% for HSV-2 [9-12]. Lymphoid cells in association with lymphohistiocytic aggregates showed rare viral inclusions. Of note, in some of these patients, serum IgG is normal and ANA at first screening may be negative and thus the clinician may not consider AIH, although a more appropriate autoimmune liver serology test could be contributory.

Such individuals are thought to be protected against HBV infection and do not require postexposure treatment. It is caused by an RNA virus that produces acute infection only. Similarly, blood smears are generally used to diagnose Trypanosoma cruzi, in the context of exposure to the appropriate “kissing bugs”, sleeping environment, and in the areas known to have this disease. These effects are thought to be mediated by circulating endotoxin and tumor necrosis factor. Since then, these have also been detected in the kidney, stomach, and liver [29, 83]. Herpes simplex virus (HSV) is extremely common throughout North America and the world. The serologic diagnosis of acute hepatitis D can be difficult.

Early treatment with intravenous acyclovir is associated with improved outcomes in patients with HSV hepatitis, but there is little experience to guide when, if ever, it is safe to transition to oral therapy. Interestingly, our case of acute HSV hepatitis presented significantly different imaging findings from those described in previous reports. Shortly after starting treatment with acyclovir, the patient’s symptoms improved and her transaminase levels began to decline, further supporting the diagnosis of HSV infection. While liver biopsy has historically been the gold standard for diagnosis of HSV hepatitis, serum HSV PCR is becoming the diagnostic modality of choice with a high sensitivity and specificity [4]. Furthermore, to our knowledge, this is only the second reported case of HSV hepatitis mimicking hepatic abscesses on CT and MRI [8]. They both generally affect immunocompromised individuals as a result of de novo infection or reactivation of the latent infection. Kumar A, Beniwal M, Kar P, Sharma JB, Murthy NS.

Although both HSV-1 and HSV-2 have been reported to cause similar complications, our case series describes three patients with sexually acquired genital HSV-2, complicated by necrotizing herpes hepatitis. Regardless, she was started on an N-acetylcysteine infusion as treatment for a possible late presentation of acetaminophen toxicity. Hepatitis is an unusual manifestation of HSV infection. Autoimmune hepatitis. References: ========== Abramson N, Melton B. Routine biochemical liver function tests were performed systematically throughout the clinical course of all patients. Slight lower abdominal tenderness was the only clinical abnormality.

1). She was hemodynamically unstable on presentation with a heart rate of 114 beats per minute and a blood pressure of 71/40mmHg. The acquisition of herpes simplex virus during pregnancy. They remind us to: eat a balanced diet, get the proper amount of sleep and exercise, avoid excesses of caffeine and alcohol, stayaway from tobacco, and be careful to manage chronic stress. She did not have any predisposing skin conditions for the development of eczema herpeticum, for example, atopic dermatitis. She progressed to respiratory failure requiring intubation and mechanical ventilation. Mucocutaneous signs are present in only 57 to 70% of cases.

A male to female ratio of 2:1 was noticed for both. Seroconversion of her serum-antibody status demonstrated that she acquired a primary infection in that her HSV-2 IgM became negative after treatment and her HSV-2 IgG was positive. Laboratory investigation revealed severe acute hepatitis with thrombocytopenia and coagulopathy. After hepatectomy, greater than 95% of hepatocytes enter into S-phase within 48 hours. In atypical cases, it is important to consider other causes, such as herpes simplex virus (HSV) hepatitis. Herpes simplex virus (HSV) hepatitis represents a rare complication of HSV infection, which can progress to acute liver failure and, in some cases, death. Fulminant hepatitis due to herpes simplex virus (HSV) in adults is a rare and deadly disease.