Fulminant hepatic failure from herpes simplex virus: post liver transplantation acyclovir therapy and literature review.

INTRODUCTION: Herpes simplex virus (HSV) is seen throughout the world and can be treated with acyclovir. We present a case of fulminant hepatic failure (FHF) as a result of disseminated HSV infection in a pregnant patient during the second trimester.

METHODS: The medical records of a patient suffering from HSV-related fulminant hepatic failure were collected. A review of the literature was collected and reported.

RESULTS: A previously healthy female presented with fulminant hepatic failure at a local emergency room complaining of a 5-day history of fever, nausea, vomiting, and right side abdominal pain that radiated to the back. She was diagnosed with fulminant hepatic failure and progressed into a coma. The patient underwent orthotopic liver transplantation (OLT) prior to the diagnosis of HSV and then treated successfully with acyclovir.

CONCLUSION: Treatment of HSV fulminant hepatitis is dependent up on early suspicion and prompt intervention. In addition, antiviral therapy may need to be lifelong.