Digestive Diseases and Sciences

, Volume 45, Issue 12, pp 2399–2404

Herpes Simplex-Induced Fulminant Hepatitis In Adults

  • David J. Peters
  • Wallace H. Greene
  • Francesca Ruggiero
  • Thomas J. McGarrity
Article

DOI: 10.1023/A:1005699210816

Cite this article as:
Peters, D.J., Greene, W.H., Ruggiero, F. et al. Dig Dis Sci (2000) 45: 2399. doi:10.1023/A:1005699210816

Abstract

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.

fulminant hepatitisherpes simplexacyclovir

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • David J. Peters
    • 1
  • Wallace H. Greene
    • 1
  • Francesca Ruggiero
    • 1
  • Thomas J. McGarrity
    • 1
  1. 1.Departments of Medicine and Pathology, The Milton S. Hershey Medical CenterThe Pennsylvania State University College of Medicine, PennState Geisinger Health SystemHershey