Abdominal Imaging

, Volume 29, Issue 6, pp 682–684

Fulminant herpes hepatitis in an immunocompetent pregnant woman: CT imaging features

Original article

Abstract

Fulminant hepatitis due to herpes simplex virus (HSV) is rare in immunocompetent adults. Most reported cases have clearly established pregnancy as a condition that can predispose to disseminated HSV infection. We report a case of a 25-year-old previously healthy pregnant woman who presented with fatigue, fever, and anicteric hepatitis. Triphasic contrast-enhanced computed tomography demonstrated a miliary pattern of multiple, hypovascular, subcentimeter lesions scattered throughout the liver. Familiarity with the clinical findings and computed tomographic appearance may prompt early recognition of fulminant HSV hepatitis and allow differentiation from other hepatic disease during pregnancy.

Liver infection Computed tomography Herpes simplex virus Pregnancy 

References

  1. 1.
    Riely, CA 1994Hepatic disease in pregnancyAm J Med9618S22SCrossRefPubMedGoogle Scholar
  2. 2.
    Kang, AH, Graves, CR 1999Herpes simplex hepatitis in pregnancy: a case report and review of the literatureObstet Gynecol Surv54463468CrossRefPubMedGoogle Scholar
  3. 3.
    Chase, RA, Pottage, JC Jr, Haber, MH,  et al. 1987Herpes simplex hepatitis in adults: two case reports and review of the literatureRev Infect Dis9329333PubMedGoogle Scholar
  4. 4.
    Mortele, KJ, Ros, PR 2001Imaging of diffuse liver diseaseSemin Liver Dis21195212CrossRefPubMedGoogle Scholar
  5. 5.
    Johnson, JR, Egaas, S, Gleaves, CA,  et al. 1992Hepatitis due to herpes simplex virus in marrow-transplant patientsClin Infect Dis143845PubMedGoogle Scholar
  6. 6.
    Hufert, FT, Diebold, T, Ermisch, B,  et al. 1995Liver failure due to disseminated HSV-1 infection in a newborn twinScan J Infect Dis27627629Google Scholar
  7. 7.
    Johnson, LG, Saldana, LR 1994HSV hepatitis in pregnancy. A case reportJ Reprod Med39544546PubMedGoogle Scholar
  8. 8.
    Yaziji, H, Hill, T, Pitman, T,  et al. 1997Gestational herpes simplex virus hepatitisSouth Med J90347351PubMedGoogle Scholar
  9. 9.
    Brown, ZA, Selke, S, Zeh, J,  et al. 1997The acquisition of herpes simplex virus during pregnancyN Engl J Med337509515CrossRefPubMedGoogle Scholar
  10. 10.
    Frederick, DM, Bland, D, Gollin, Y 2002Fatal disseminated herpes simplex virus infection in a previously healthy pregnant woman. A case reportJ Reprod Med47591596PubMedGoogle Scholar
  11. 11.
    Klein, NA, Mabie, WC, Shaver, DC,  et al. 1991Herpes simplex virus hepatitis in pregnancy. Two patients successfully treated with acyclovirGastroenterology100239244PubMedGoogle Scholar
  12. 12.
    Wolfsen, HC, Bolen, JW, Bowen, JL, Fenster, LF 1993Fulminant herpes hepatitis mimicking hepatic abscessesJ Clin Gastroenterol166164PubMedGoogle Scholar
  13. 13.
    Ruehm, SG, Trojan, A, Vogt, P,  et al. 1998CT appearances of hepatic involvement in systemic varicella-zosterBr J Radiol7113171319PubMedGoogle Scholar
  14. 14.
    Byrd, DE, Riely, CA 1996Liver disease in preeclampsiaGastroenterologist46569PubMedGoogle Scholar
  15. 15.
    Mortele, KJ, Cantisani, V, Brown, DL, Ros, PR 2003Spontaneous intraperitoneal hemorrhage: imaging featuresRadiol Clin North Am4111831201PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 2004

Authors and Affiliations

  1. 1.Division of Abdominal Imaging and Intervention, Department of RadiologyBrigham and Women’s HospitalBostonUSA

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