title: Herpes simplex virus type 1 hepatitis due to primary infection in a pancreas-kidney transplant recipient.
abstract: Herpes simplex Virus (HSV) hepatitis is a rare complication of HSV-1 primary infection, with a delayed diagnosis, affecting mainly immunocompromised patients. We describe a case of HSV-1 hepatitis after primary infection occurring in the postoperative days after a pancreas-kidney transplantation. The patient presented with an unusual evolution of a persistent severe hepatitis associated with a persistent viremia (Quantitative Polymerase Chain Reaction) despite an adequate intravenous (iv) antiviral treatment. Abdominal computed tomography scan showed a miliary hepatitis. The diagnosis of HSV-1 hepatitis was confirmed by immuno-chemistry on liver biopsy. The donor was negative for anti-HSV antibodies, excluding contamination by the graft. This case report emphasizes a rather seldom risk of care-associated viral infections, predominantly in immunocompromised patients.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vandoeuvre-Les-Nancy F-54511, France; University of Lorraine, F-54000 Nancy, France.
authors.forename: J
authors.initials: J
authors.lastname: Feugeas
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vandoeuvre-Les-Nancy F-54511, France.
authors.forename: S
authors.initials: S
authors.lastname: Mory
authors.affiliation: Virology Laboratory, University Hospital of Nancy, Vandoeuvre-lès-Nancy F-54511, France; University of Lorraine, F-54000 Nancy, France.
authors.forename: H
authors.initials: H
authors.lastname: Jeulin
authors.affiliation: Virology Laboratory, University Hospital of Nancy, Vandoeuvre-lès-Nancy F-54511, France.
authors.forename: A
authors.initials: A
authors.lastname: Velay
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vandoeuvre-Les-Nancy F-54511, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Pertek
authors.affiliation: Department of Nephrology, University Hospital of Nancy, 54511 Vandoeuvre-les-Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Ladriere
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vandoeuvre-Les-Nancy F-54511, France; University of Lorraine, F-54000 Nancy, France. Electronic address: mr.losser@chru-nancy.fr.
authors.forename: M-R
authors.initials: MR
authors.lastname: Losser
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000821:virology; D005260:Female; D006525:Hepatitis, Viral, Human / Q000175:diagnosis*; D006561:Herpes Simplex / Q000175:diagnosis*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects; D016035:Pancreas Transplantation / Q000009:adverse effects
keywords: Healthcare-associated infections; Hepatitis; Herpes simplex virus; Polymerase chain reaction; Solid organ transplant