Fatal Septic Shock Associated with Herpes Simplex Virus Hepatitis: A Case Report

Inthasot, Valentine and Goushchi, Adonis and Lazzaroni, Silvia and Papaleo, Alberto and Gomez Galdon, Maria and Chochrad, Didier (2018) Fatal Septic Shock Associated with Herpes Simplex Virus Hepatitis: A Case Report. European Journal of Case Reports in Internal Medicine, 5 (12). ISSN 2284-2594

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Herpes simplex viruses are endemic worldwide, with an estimated seroprevalence of approximately 70% in developed countries. However, it is less well known that they are one of the viral causes of fulminant hepatitis (<2%) and constitute <1% of all causes of acute liver failure. We describe the case of an 89-year-old man who developed sepsis caused by a urinary tract infection due to drug-sensitive Escherichia coli. After empirical treatment with piperacillin-tazobactam was initiated, the patient’s condition worsened with shock, acute liver and renal failure, encephalopathy and persistent fever, that led to admission to the intensive care unit. The emergence of an acute abdomen prompted exploratory laparotomy but the patient died soon after surgery from abdominal haemorrhage. Immunohistochemical analysis of a liver biopsy specimen identified herpes simplex virus (HSV) hepatitis. The authors emphasize the need for better understanding of this rare condition in order to more precisely identify patients at risk who need more aggressive evaluation and empirical treatment, especially patients presenting with marked hepatic cytolysis with a rapidly worsening clinical evolution.

Item Type: Article
Uncontrolled Keywords: Acute liver failure, hepatitis, herpes simplex virus, septic shock
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Greta Di Blasio
Date Deposited: 10 Jun 2019 16:18
Last Modified: 10 Jun 2019 16:18
URI: http://eprints.bice.rm.cnr.it/id/eprint/18810

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