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Recurrent Herpetic Stromal Keratitis in Mice, a Model for Studying Human HSK

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Published on: December 18, 2012

Fulminant hepatic failure for herpes simplex virus.

Sanjeev S Chatni¹, V Sooraj, Gourav Pande

¹Department of Gastroenterology, Amrita Institute of Medical Sciences and Research Centre, Cochin.

Journal of the Indian Medical Association

|August 19, 2008

Summary

Fulminant hepatic failure from herpes simplex virus infection is rare in immunocompetent individuals. Early diagnosis is challenging due to lack of skin lesions, but clues include elevated transaminases and leukopenia.

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Area of Science:

Hepatology
Virology
Infectious Diseases

Background:

Fulminant hepatic failure (FHF) is a rare but severe complication of herpes simplex virus (HSV) infection.
Immunocompetent individuals can develop FHF, often without typical mucocutaneous manifestations, complicating early diagnosis.

Observation:

A 43-year-old immunocompetent female presented with a one-week history of jaundice, anorexia, nausea, and vomiting.
Physical examination revealed hepatomegaly. Laboratory investigations showed markedly elevated transaminases and coagulopathy.

Findings:

Herpes simplex virus IgM (enzyme-linked immunosorbent assay) was positive, confirming HSV infection.
Despite treatment with acyclovir, the patient experienced a fatal outcome.

Implications:

This case highlights the diagnostic challenges of HSV-induced FHF in immunocompetent patients, particularly when mucocutaneous lesions are absent.
Prompt recognition of clinical and laboratory clues, such as elevated transaminases and leukopenia, is crucial for timely intervention.
The fatality underscores the aggressive nature of HSV-FHF and the need for continued research into effective treatment strategies.