1/75. Fatal herpetic hepatitis in adult following short corticotherapy: a case report.herpes simplex virus hepatitis (HSV hepatitis) is an uncommon and severe complication of HSV type 1 and HSV type 2 infection. HSV hepatitis affects mostly immunocompromised patients. We report the case of a young man without any previous known immunodeficiency who developed fatal HSV hepatitis in the first 8 days of oral corticotherapy given for ulcerative colitis. A prompt diagnosis was possible because HSV was recovered from peripheral blood leukocytes.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/75. Fulminant herpes hepatitis in a healthy adult: a treatable disorder?Hepatitis due to herpes simplex virus (HSV) is a potentially fatal disorder that is often not considered in the differential diagnosis of acute hepatitis. This disease occurs most often in patients with impaired immunity and is very uncommon in healthy patients. HSV hepatitis presents with a wide clinical spectrum, and the clinical diagnosis is difficult. We describe a case of disseminated herpes virus infection with fulminant hepatitis mimicking an acute human immunodeficiency virus infection in a 33-year-old healthy man. Preliminary studies suggest that early treatment of HSV hepatitis with acyclovir may be beneficial in these patients. A high index of suspicion and the availability of early diagnostic tools, such as HSV dna detection, may dramatically improve the clinical outcome of severe HSV hepatitis.- - - - - - - - - - ranking = 1.125keywords = hepatitis (Clic here for more details about this article) |
3/75. herpes simplex hepatitis in pregnancy: a case report and review of the literature.Fulminant hepatic dysfunction in the third trimester of pregnancy accompanied by fever may result from disseminated herpes simplex virus. Since 1969, 24 cases of herpes simplex hepatitis, including the current case, have been reported. Mucocutaneous lesions are present in only half of cases; therefore, suspicion for diagnosis of this disease is low. Twenty-five percent of cases were not diagnosed until autopsy. Maternal and perinatal mortality are high, approaching 39 percent for both mother and fetus. Early recognition with initiation of antiviral therapy appears to be most important in maximizing survival.- - - - - - - - - - ranking = 0.625keywords = hepatitis (Clic here for more details about this article) |
4/75. Presence of herpes simplex virus (HSV) in peripheral leukocytes of patient who developed active HSV infection after bone marrow transplantation.BACKGROUND: Despite of prophylactic antiviral therapy, latent HSV may be reactivated in bone marrow transplant (BMT) recipients and cause serious disease. Rapid diagnosis of HSV infection is needed to prompt institution of appropriate therapy. OBJECTIVES: We report a case of the allogenic BMT recipient, who developed ulcerative esophagitis which progressed to generalized HSV infection and graft versus host reaction (GVHR).We consider several diagnostic approaches to detection of active HSV infection in this patient. STUDY DESIGN: polymerase chain reaction (PCR) was used to detect HSV dna in esophageal biopsy specimens and peripheral leukocytes (PBL). Isolation of HSV in tissue culture was performed to prove infectious virus in swabs from mucocutaneous lesions or in PBL. RESULTS: Using PCR, HSV dna was detected in peripheral leukocytes of the patient who had developed generalized HSV infection accompanied with hepatosplenomegaly and hepatitis. At that time, a fully infectious ACV-resistant HSV was isolated from his PBL. On the other hand, HSV dna was not detected in PBL of other BMT-recipients with skin- or organ-localized infection. CONCLUSIONS: Presence of HSV-dna in PBL of BMT recipients can signalize generalized HSV infection. Isolation of HSV from PBL by cocultivation with human fibroblasts can be used as an alternative diagnostic approach in these patients.- - - - - - - - - - ranking = 0.125keywords = hepatitis (Clic here for more details about this article) |
5/75. A baby, a virus, and a rat.The authors present a case initially thought to be a child abuse homicide that, after complete autopsy and thorough investigation, was determined to be caused by a viral infection and complicated by postmortem animal activity. Neonatal herpes simplex infection and postmortem skin defects are discussed.- - - - - - - - - - ranking = 0.0012043861792592keywords = animal (Clic here for more details about this article) |
6/75. Quantitation of herpes simplex dna in blood during aciclovir therapy with competitive PCR ELISA.BACKGROUND: Monitoring viral load in blood has already been introduced into clinical routine for human immunodeficiency virus and hepatitis c virus. OBJECTIVE: This study was conducted to monitor the decline of herpes simplex (HSV) viral load in the blood of a patient with gingivostomatitis herpetica prior and during acyclovir therapy. methods: Analysis was done by quantitative PCR ELISA using an internal quantitation standard. RESULTS: Copy numbers were 66/microl blood prior to therapy, 60 during oral medication with valaciclovir, 97 and 72 copies/microl blood during the first 2 days of intravenous acyclovir therapy, followed by a sharp decline to 8 and 9 copies on days 3 and 4. During the following days, HSV was no longer detectable. Conclusion: As this quantitative approach can be easily adjusted to any other PCR, it provides a reliable, easy-to-apply method for monitoring therapy, also during new antiviral clinical trials.- - - - - - - - - - ranking = 0.125keywords = hepatitis (Clic here for more details about this article) |
7/75. herpes simplex-induced fulminant hepatitis in adults: a call for empiric therapy.herpes simplex-induced fulminant hepatitis is an infrequently reported cause of hepatitis in adults. Pregnant females and patients with impaired cellular immunity may be at increased risk, although healthy adults have been affected. The diagnosis may be underrecognized due to nonspecific presenting symptoms and lack of typical cutaneous herpes lesions. We present three cases of fatal herpes simplex fulminant hepatitis. Our review of case reports of herpes simplex hepatitis in adults demonstrates improved survival with intravenous acyclovir therapy. We believe that empiric use of acyclovir should be considered while the diagnostic evaluation of non-acetaminophen-induced fulminant hepatitis is underway. Recognition of characteristic liver function abnormalities seen with fulminant herpes simplex hepatitis include marked elevation of transaminases with AST > ALT and a mild hyperbilirubinemia (anicteric hepatitis), and they should prompt acyclovir therapy. This is especially true when there are no obvious risk factors for other forms of hepatitis.- - - - - - - - - - ranking = 1.5keywords = hepatitis (Clic here for more details about this article) |
8/75. herpes simplex virus type 1 corneal infection results in periocular disease by zosteriform spread.In humans and animal models of herpes simplex virus infection, zosteriform skin lesions have been described which result from anterograde spread of the virus following invasion of the nervous system. Such routes of viral spread have not been fully examined following corneal infection, and the possible pathologic consequences of such spread are unknown. To investigate this, recombinant viruses expressing reporter genes were generated to quantify and correlate gene expression with replication in eyes, trigeminal ganglia, and periocular tissue. Reporter activity peaked in eyes 24 h postinfection and rapidly fell to background levels by 48 h despite the continued presence of viral titers. Reporter activity rose in the trigeminal ganglia at 60 h and peaked at 72 h, concomitant with the appearance and persistence of infectious virus. Virus was present in the periocular skin from 24 h despite the lack of significant reporter activity until 84 h postinfection. This detection of reporter activity was followed by the onset of periocular disease on day 4. Corneal infection with a thymidine kinase-deleted reporter virus displayed a similar profile of reporter activity and viral titer in the eyes, but little or no detectable activity was observed in trigeminal ganglia or periocular tissue. In addition, no periocular disease symptoms were observed. These findings demonstrate that viral infection of periocular tissue and subsequent disease development occurs by zosteriform spread from the cornea to the periocular tissue via the trigeminal ganglion rather than by direct spread from cornea to the periocular skin. Furthermore, clinical evidence is discussed suggesting that a similar mode of spreading and disease occurs in humans following primary ocular infection.- - - - - - - - - - ranking = 0.0012043861792592keywords = animal (Clic here for more details about this article) |
9/75. adult-onset herpes simplex virus hepatitis with diffuse myofibroblastic transformation of hepatic stellate cells (Ito cells) in non-necrotic areas.The myofibroblastic transformation of hepatic stellate cells (HSC; also known as Ito cells) usually occurs following necrosis of adjacent liver cells. No report has previously found that such a transformation occurs in herpes simplex virus (HSV) hepatitis. We present an autopsy case of HSV hepatitis with myofibroblastic transformation of HSC that is different from the usual transformation of HSC. The patient was a 66-year-old woman who had received various therapies for cutaneous T-cell lymphoma. An autopsy revealed submassive hepatic necrosis with hemorrhage due to HSV hepatitis. HSV infection was confirmed by dna in situ hybridization in liver tissue. Immunohistochemical staining for alpha-smooth muscle actin (ASMA) showed a strong positive reaction in almost all of the HSC in non-necrotic areas. However, in necrotic areas, the HSC were completely negative for ASMA. These findings indicate that not only liver cells but also HSC can become necrotic in HSV hepatitis. In contrast, in non-necrotic areas, almost all of the HSC showed active transformation to myofibroblasts.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
10/75. Five cases of fulminant hepatitis due to herpes simplex virus in adults.Five cases of fulminant hepatitis due to herpes simplex virus were identified among patients admitted to the Thomas E. Starzl Transplantation Institute between January 1991 and September 1994. The diagnosis was established in three of the five patients on the basis of transjugular liver biopsy specimen results. These three patients were treated with acyclovir; two survived and one required liver transplantation. Early histologic diagnosis, specific antiviral treatment, and liver transplantation in selected patients may improve the clinical outcome of this almost uniformly fatal disease.- - - - - - - - - - ranking = 0.625keywords = hepatitis (Clic here for more details about this article) |
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