title: Herpetic gingivostomatitis with severe hepatitis in a previously healthy child.
abstract: A previously healthy boy aged 9 years and 11 months was admitted due to herpetic gingivostomatitis with poor intake. He also had fever, neutropenia, and elevated serum aminotransferase level (> 1000 IU/mL). Prolonged prothrombin time, mild gastrointestinal hemorrhage and transient decreased conscious level were noted during hospital days 2 and 3. Intravenous acyclovir therapy commenced on hospital day 2 and his serum aminotransferase level peaked (> 4000 IU/mL) on hospital day 3 and then improved gradually. A throat swab was positive for human herpes simplex virus (HSV)-1, serological test was positive for acute primary HSV-1 infection, and a blood specimen was also strongly positive for HSV-1 by polymerase chain reaction. He received a 14-day course of intravenous acyclovir and recovered uneventfully. Herpetic gingivostomatitis, although mostly benign and self-limited, may be complicated with severe hepatitis, even in immunocompetent hosts.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chun-Kuei
authors.initials: CK
authors.lastname: Chen
authors.forename: Shih-Hao
authors.initials: SH
authors.lastname: Wu
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D061605:Administration, Intravenous; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D005334:Fever / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006505:Hepatitis / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D018259:Herpesvirus 1, Human / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D012698:Serologic Tests; D013048:Specimen Handling; D013283:Stomatitis, Herpetic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D000637:Transaminases / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000637:Transaminases; D000212:Acyclovir