Fatal disseminated herpes simplex virus infection in a healthy child

Area of Science:

• Pediatric Infectious Diseases
• Hepatology
• Virology

Background:

• Herpes simplex virus (HSV) infections are common but typically self-limiting in immunocompetent individuals.
• Fulminant hepatitis is a rare but severe manifestation of HSV, predominantly seen in neonates.
• Disseminated HSV infection can lead to significant organ damage, including the liver.

Observation:

• An 11-month-old, previously healthy, and immunocompetent male infant presented with disseminated herpes simplex virus infection.
• The infant exhibited severe hepatic damage as a direct consequence of the viral infection.
• The clinical course was rapidly progressive, leading to a fatal outcome.

Findings:

• The post-mortem examination confirmed disseminated herpes simplex virus infection as the cause of death.
• Severe hepatic necrosis was the primary pathological finding attributed to HSV.
• This case represents a rare instance of fulminant hepatitis due to HSV in a non-neonatal, immunocompetent child.

Implications:

• This case underscores the potential for severe HSV hepatitis in immunocompetent infants beyond the neonatal period.
• It highlights the importance of considering HSV as a cause of severe hepatitis in infants, even without typical risk factors.
• Early recognition and management of disseminated HSV infections are critical to prevent fatal outcomes and severe organ damage.