Severe acute hepatitis due to herpes simplex virus type 2 as the initial manifestation of disseminated infection in an immunocompetent patient
DOI:
https://doi.org/10.62059/zd8hv277Keywords:
Acute hepatitis, Herpes simplex virus type 2, Disseminated infection, Acute liver failure, Immunocompromised stateAbstract
Herpes simplex virus hepatitis is an uncommon cause of severe acute hepatitis and acute liver failure, associated with high morbidity and mortality when antiviral treatment is delayed. Although more frequent in immunocompromised patients and pregnant women, it can occur in immunocompetent individuals. We describe the case of a 44-year-old woman, with no known immunosuppression, who was admitted with severe acute hepatitis, jaundice, coagulopathy, and pancytopenia. During the course of her illness, it was interpreted as probable sepsis of biliary origin, and a cholecystectomy with liver biopsy was performed, revealing extensive geographic necrosis. She subsequently developed neurological involvement, and disseminated herpes simplex virus type 2 infection was confirmed by polymerase chain reaction in plasma and cerebrospinal fluid. She responded favorably to acyclovir. Early suspicion and empirical initiation of antiviral treatment can significantly improve the prognosis.
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Copyright (c) 2026 Dra. Brenda Griboff, Dr. Guillermo Zalazar, Dra. Malen Aguirre, Dra. Laura Garrido, Dra. Maria Ana (Autor/a)
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