Disseminated neonatal herpes simplex virus (HSV) infection is characterized by progressive multiple organ failure and high mortality rates up to 85 for untreated neonates. Mieli-Vergani G. Neonatal herpes simplex virus infection presenting as acute liver failure: Prevalent role of herpes simplex virus type I. We report three cases of neonatal herpes simplex virus (HSV) infection presenting as fulminant hepatitis. None of the patients had clear risk factors for HSV infection and they all died. Case Report. Neonatal herpes simplex virus (HSV) infection manifests either as skin, eye, mouth (SEM) disease, central nervous system (CNS) disease, or disseminated disease. We present a 3-week old infant whose clinical presentation of disseminated HSV-2 infection included only compensated hepatic failure. She went on to develop fulminant hepatic failure and respiratory arrest on day of life 35 8.
Neonatal HSV hepatitis is frequently associated with acute liver failure and high mortality. Previous case reports of herpetic hepatitis describe fulminant hepatitis with liver biopsies showing multiple necrotic areas, possibly consistent with the hypoechoic ultrasound lesions seen in this case (8). Three cases of neonatal herpes simplex virus infection presenting as fulminant hepatitis. Herpes simplex virus is a commonly acquired infection. Herpes simplex infection is most commonly a benign, self-limiting disease with mucocutaneous lesions and mild viremia. Immunosuppressed patients are at a higher risk of disseminated infection, as are neonates and pregnant women. The incidence of fulminant herpes simplex virus hepatitis is extremely low, and the diagnosis is often missed due to the lack of specific signs or symptoms. In a review of 137 cases of HSV hepatitis, the most common presenting features were fever (98 ), coagulopathy (84 ), and encephalopathy (80 ).
A 19 year old primigravida presented at 32 weeks of. Prolonged maternal postpartum fever and neonatal herpes infection. An increase in circulating lymphocytes can be seen following infections such as infectious mononucleosis and pertussis, or in lymphoproliferative disorders such as acute and chronic lymphocytic leukemia. This case report shows that herpes simplex virus type 1 is a possible cause of an acute lymphocytic crisis similar to other well known infectious agents such as Epstein Barr virus, cytomegalovirus, human immunodeficiency virus, human herpes virus type 6, adenovirus, toxoplasma and human T-cell lymphotropic virus. Furthermore, this case report expands the clinical spectrum of herpes simplex virus hepatitis, since it is reported in a nonimmunocompromised patient presenting with atypical acute lymphocytic syndrome.
Neonatal Herpetic Hepatitis