Fulminant hepatic failure from herpes simplex virus: post liver transplantation acyclovir therapy and literature review.
BACKGROUND
Herpes simplex virus (HSV) is seen throughout the world and can be treated with acyclovir. We present a case of fulminant hepatic failure (FHF) as a result of disseminated HSV infection in a pregnant patient during the second trimester.


METHODS
The medical records of a patient suffering from HSV-related fulminant hepatic failure were collected. A review of the literature was collected and reported.


RESULTS
A previously healthy female presented with fulminant hepatic failure at a local emergency room complaining of a 5-day history of fever, nausea, vomiting, and right side abdominal pain that radiated to the back. She was diagnosed with fulminant hepatic failure and progressed into a coma. The patient underwent orthotopic liver transplantation (OLT) prior to the diagnosis of HSV and then treated successfully with acyclovir.


CONCLUSIONS
Treatment of HSV fulminant hepatitis is dependent up on early suspicion and prompt intervention. In addition, antiviral therapy may need to be lifelong.
Montalbano
M
M
University of Cincinnati, Division for Digestive Diseases, Cincinnati, Ohio, USA.
Slapak-Green
G I
GI
Neff
G W
GW
D000212:Acyclovir / Q000627:therapeutic use*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D022781:Hepatocytes / Q000473:pathology; D006561:Herpes Simplex / Q000150:complications* / Q000188:drug therapy; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D006801:Humans; D017114:Liver Failure, Acute / Q000188:drug therapy / Q000601:surgery* / Q000821:virology*; D011184:Postoperative Period
D000998:Antiviral Agents; D000212:Acyclovir