title: Fulminant hepatic failure due to herpes simplex after hysteroscopy.
abstract: BACKGROUND
  Fulminant hepatic failure due to herpes simplex in healthy adults is a rare condition with a high mortality rate. The lack of specific symptoms and the absence of typical herpetic lesions in a majority of cases contribute to delayed diagnosis.
  
  
  METHODS
  We describe a fatal case of fulminant hepatic failure due to herpes simplex in a healthy woman presenting after laparoscopy and hysteroscopy for tubal infertility. The patient lacked evidence of mucocutaneous lesions or jaundice. The surgery likely contributed to viral dissemination.
  
  
  CONCLUSIONS
  Although rare, disseminated herpes should be considered a possible cause of postsurgical pelvic infections, even in the absence of ulcerative lesions. Until a definitive diagnosis is made, antiviral therapy should be considered in patients with high fever, leukopenia, and abnormal liver function.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Greenville Hospital System, Greenville, South Carolina 29605, USA. tprice@ghs.org
authors.forename: T M
authors.initials: TM
authors.lastname: Price
authors.forename: J B
authors.initials: JB
authors.lastname: Harris
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006561:Herpes Simplex / Q000150:complications*; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000601:surgery; D017093:Liver Failure / Q000209:etiology* / Q000821:virology; D011183:Postoperative Complications / Q000209:etiology