Primary disseminated herpes simplex infection with fulminant hepatitis following renal transplantation

A patient had disseminated herpes simplex, type 1, virus infection manifested by fulminant hepatitis and disseminated intravascular coagulation. The diagnosis was established by isolation of the virus from throat, urine, and buffy coat and confirmed at autopsy by the visualization of typical inclusions, demonstration of herpesvirus particles by electron microscopy, and specific immunoperoxidase staining. Therapy with vidarabine did not alter the fatal course. On the basis of clinical features and serologic results, the case represented a disseminated primary infection with herpes simplex, rather than reactivation of an endogenous infection, following renal transplantation.