title: Fulminant hepatic failure secondary to acyclovir-resistant herpes simplex virus.
abstract: Liver failure is a frequent and serious complication that causes morbidity and mortality in haematopoietic stem cell transplantation (HCT) recipients. Liver dysfunction in these patients can be related to infectious causes, most common viral hepatitis. We report a case of disseminated acyclovir-resistant herpes simplex virus (HSV) infection following HCT that led to acute liver failure and death. Although rare, HSV hepatitis leads to high morbidity and mortality and should be considered in the differential diagnosis of HCT recipients with marked elevation of hepatic transaminase. Acyclovir is a first-line therapy for HSV infection; however, acyclovir-resistant viral strains should be considered and alternative HSV therapies given in HCT recipients whose HSV infection does not improve on acyclovir therapy.
authors.affiliation: McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Lokesh
authors.initials: L
authors.lastname: Shahani
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D024882:Drug Resistance, Viral; D006525:Hepatitis, Viral, Human / Q000821:virology; D006561:Herpes Simplex / Q000188:drug therapy*; D018258:Herpesvirus 2, Human; D006801:Humans; D017114:Liver Failure, Acute / Q000000981:diagnostic imaging / Q000821:virology*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir