Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure
Identifieur interne : 000805 ( Pmc/Checkpoint ); précédent : 000804; suivant : 000806Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure
Auteurs : Rachel A. Poley [Canada] ; Jaime F. Snowdon [Canada] ; Daniel W. Howes [Canada]Source :
- Case Reports in Critical Care [ 2090-6420 ] ; 2011.
Abstract
Url:
DOI: 10.1155/2011/138341
PubMed: 24826316
PubMed Central: 4010022
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure</title>
<author><name sortKey="Poley, Rachel A" sort="Poley, Rachel A" uniqKey="Poley R" first="Rachel A." last="Poley">Rachel A. Poley</name>
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<author><name sortKey="Snowdon, Jaime F" sort="Snowdon, Jaime F" uniqKey="Snowdon J" first="Jaime F." last="Snowdon">Jaime F. Snowdon</name>
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<author><name sortKey="Howes, Daniel W" sort="Howes, Daniel W" uniqKey="Howes D" first="Daniel W." last="Howes">Daniel W. Howes</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure</title>
<author><name sortKey="Poley, Rachel A" sort="Poley, Rachel A" uniqKey="Poley R" first="Rachel A." last="Poley">Rachel A. Poley</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Emergency Medicine and Department of Critical Care Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 2V7</nlm:aff>
<country>Canada</country>
<wicri:regionArea>Department of Emergency Medicine and Department of Critical Care Medicine, Kingston General Hospital, Queen's University, Kingston, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
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<author><name sortKey="Snowdon, Jaime F" sort="Snowdon, Jaime F" uniqKey="Snowdon J" first="Jaime F." last="Snowdon">Jaime F. Snowdon</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Pathology, Queen's University, Kingston, ON, Canada K7L 3N6</nlm:aff>
<country>Canada</country>
<wicri:regionArea>Department of Pathology, Queen's University, Kingston, ON</wicri:regionArea>
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<author><name sortKey="Howes, Daniel W" sort="Howes, Daniel W" uniqKey="Howes D" first="Daniel W." last="Howes">Daniel W. Howes</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Emergency Medicine and Department of Critical Care Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 2V7</nlm:aff>
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<wicri:regionArea>Department of Emergency Medicine and Department of Critical Care Medicine, Kingston General Hospital, Queen's University, Kingston, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
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<series><title level="j">Case Reports in Critical Care</title>
<idno type="ISSN">2090-6420</idno>
<idno type="eISSN">2090-6439</idno>
<imprint><date when="2011">2011</date>
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<front><div type="abstract" xml:lang="en"><p><italic>Objective</italic>
. To present a case of a healthy 41-year-old female who developed fulminant hepatic failure leading to death. The cause of hepatic failure identified on postmortem exam was herpes simplex virus hepatitis. <italic>Design</italic>
. Observation of a single patient. <italic>Setting</italic>
. Intensive care unit of a tertiary care university teaching hospital in Canada. <italic>Patient</italic>
. 41-year-old previously healthy female presenting with a nonspecific viral illness and systemic inflammatory response syndrome. <italic>Intervention</italic>
. The patient was treated with intravenous fluids and broad-spectrum antibiotics. On the second day of admission, she was found to have elevated transaminases, and, over 48 hours, she progressed to fulminant liver failure with disseminated intravascular coagulopathy, refractory lactic acidosis, and shock. She progressed to respiratory failure requiring intubation and mechanical ventilation. She was started on N-acetylcysteine, a bicarbonate infusion, hemodialysis, and multiple vasopressors and inotropes. <italic>Measurements and Main Results</italic>
. Despite treatment, the patient died roughly 70 hours after her initial presentation to hospital. Her postmortem liver biopsy revealed herpes simplex virus hepatitis as her cause of death. <italic>Conclusions</italic>
. Herpes simplex virus must be considered in all patients presenting with liver failure of unknown cause. If suspected, prompt treatment with acyclovir should be initiated.</p>
</div>
</front>
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<pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Crit Care</journal-id>
<journal-id journal-id-type="iso-abbrev">Case Rep Crit Care</journal-id>
<journal-id journal-id-type="publisher-id">CRIM.CRITICAL.CARE</journal-id>
<journal-title-group><journal-title>Case Reports in Critical Care</journal-title>
</journal-title-group>
<issn pub-type="ppub">2090-6420</issn>
<issn pub-type="epub">2090-6439</issn>
<publisher><publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24826316</article-id>
<article-id pub-id-type="pmc">4010022</article-id>
<article-id pub-id-type="doi">10.1155/2011/138341</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Poley</surname>
<given-names>Rachel A.</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Snowdon</surname>
<given-names>Jaime F.</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Howes</surname>
<given-names>Daniel W.</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Emergency Medicine and Department of Critical Care Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 2V7</aff>
<aff id="I2"><sup>2</sup>
Department of Pathology, Queen's University, Kingston, ON, Canada K7L 3N6</aff>
<author-notes><corresp id="cor1">*Rachel A. Poley: <email>raply@mta.ca</email>
</corresp>
<fn fn-type="other"><p>Academic Editors: M. Egi and K. S. Waxman</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>7</day>
<month>12</month>
<year>2011</year>
</pub-date>
<volume>2011</volume>
<elocation-id>138341</elocation-id>
<history><date date-type="received"><day>27</day>
<month>7</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>18</day>
<month>9</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2011 Rachel A. Poley et al.</copyright-statement>
<copyright-year>2011</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p><italic>Objective</italic>
. To present a case of a healthy 41-year-old female who developed fulminant hepatic failure leading to death. The cause of hepatic failure identified on postmortem exam was herpes simplex virus hepatitis. <italic>Design</italic>
. Observation of a single patient. <italic>Setting</italic>
. Intensive care unit of a tertiary care university teaching hospital in Canada. <italic>Patient</italic>
. 41-year-old previously healthy female presenting with a nonspecific viral illness and systemic inflammatory response syndrome. <italic>Intervention</italic>
. The patient was treated with intravenous fluids and broad-spectrum antibiotics. On the second day of admission, she was found to have elevated transaminases, and, over 48 hours, she progressed to fulminant liver failure with disseminated intravascular coagulopathy, refractory lactic acidosis, and shock. She progressed to respiratory failure requiring intubation and mechanical ventilation. She was started on N-acetylcysteine, a bicarbonate infusion, hemodialysis, and multiple vasopressors and inotropes. <italic>Measurements and Main Results</italic>
. Despite treatment, the patient died roughly 70 hours after her initial presentation to hospital. Her postmortem liver biopsy revealed herpes simplex virus hepatitis as her cause of death. <italic>Conclusions</italic>
. Herpes simplex virus must be considered in all patients presenting with liver failure of unknown cause. If suspected, prompt treatment with acyclovir should be initiated.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" position="float"><label>Figure 1</label>
<caption><p>Zones of hepatocyte necrosis surrounded by hemorrhage without significant inflammation. (100x magnification; Hematoxylin-Phloxine-Saffron (HPS) stain.)</p>
</caption>
<graphic xlink:href="CRIM.CRITICAL.CARE2011-138341.001"></graphic>
</fig>
<fig id="fig2" position="float"><label>Figure 2</label>
<caption><p>Viral inclusions are readily visible in infected hepatocytes. (600x magnification; Hematoxylin-Phloxine-Saffron (HPS) stain.)</p>
</caption>
<graphic xlink:href="CRIM.CRITICAL.CARE2011-138341.002"></graphic>
</fig>
<fig id="fig3" position="float"><label>Figure 3</label>
<caption><p>Immunohistochemistry for HSV virus highlights viral inclusions (600x magnification).</p>
</caption>
<graphic xlink:href="CRIM.CRITICAL.CARE2011-138341.003"></graphic>
</fig>
</floats-group>
</pmc>
<affiliations><list><country><li>Canada</li>
</country>
</list>
<tree><country name="Canada"><noRegion><name sortKey="Poley, Rachel A" sort="Poley, Rachel A" uniqKey="Poley R" first="Rachel A." last="Poley">Rachel A. Poley</name>
</noRegion>
<name sortKey="Howes, Daniel W" sort="Howes, Daniel W" uniqKey="Howes D" first="Daniel W." last="Howes">Daniel W. Howes</name>
<name sortKey="Snowdon, Jaime F" sort="Snowdon, Jaime F" uniqKey="Snowdon J" first="Jaime F." last="Snowdon">Jaime F. Snowdon</name>
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