title: Case report: benefits of quantitative polymerase chain reaction in the clinical management of herpes simplex virus 1 infection with prominent hepatitis and unusual secondary progression.
abstract: Herpes simplex virus (HSV) infection is rarely considered in the differential diagnosis of severe acute hepatitis and disseminated infection in immunocompetent adults. A case of disseminated HSV-1 infection in an 82-year-old woman initially presenting with neurological problems, signs of meningitis and prominent hepatitis was investigated. Initial diagnosis, monitoring, and follow-up were based on the application of molecular methods to cerebrospinal fluid, serum, and liver tissue samples from this patient. Following an initial full recovery, the patient presented delayed intracerebral haemorrhage and diffuse arthralgia. This atypical case, with delayed secondary progression, highlights the wide range of clinical features of HSV infection and the benefits of monitoring viral load by quantitative real-time polymerase chain reaction (PCR) during patient management.
authors.affiliation: Service de Bactériologie-Virologie, CHRU Bretonneau, Tours Cedex, France. antoine.chaillon@univ-tours.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Chaillon
authors.forename: Nathalie
authors.initials: N
authors.lastname: Schnepf
authors.forename: Maud
authors.initials: M
authors.lastname: Jonas
authors.forename: Karl
authors.initials: K
authors.lastname: Mondon
authors.forename: Isabelle
authors.initials: I
authors.lastname: Orain
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lioger
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Cottier
authors.forename: Caroline
authors.initials: C
authors.lastname: Hommet
authors.forename: Alain
authors.initials: A
authors.lastname: Goudeau
mesh_terms: D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis; D060085:Coinfection; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006525:Hepatitis, Viral, Human / Q000175:diagnosis* / Q000188:drug therapy; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008279:Magnetic Resonance Imaging; D008582:Meningitis, Aseptic / Q000175:diagnosis / Q000209:etiology; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D000914:Antibodies, Viral