Abstract
Rapidly Progressive Acute Hepatitis in a Patient with Disseminated Herpes Simplex Infection: A Case Report
Tim Lawrence Lin, MD1, Adrian Kevin Agonoy, MD2, Roel Galang, MD1 , Nikko Theodore Raymundo, MD1, Joseph Erwin Dumagpi, MD1
St. Luke’s Medical Center, Global City
Significance: Herpes Simplex Virus (HSV) infection is one of the most common sexually transmitted infections in the world. HSV-1 and HSV-2 primarily affect oral and genitourinary tracts, respectively, however may have atypical presentations involving other remote body systems including the central nervous system, the lungs, and rarely, the liver.
Clinical Presentation: We present a case of a hypertensive, nulliparous 36 year old female with history of bacterial vaginosis, coming in with a chief complaint of abdominal pain was ultimately diagnosed as a case of Disseminated Herpes Simplex presenting with fever, dysuria, and right upper quadrant abdominal pain, with ancillary diagnostics including persistent leukopenia with neutrophilic predominance, severely elevated ALT and AST reaching more than 1000 mg/dL. A diagnostic laparoscopy of the abdomen was eventually done noting remarkable erythema, and gross ulceration of the liver suspicious for HSV hepatitis (Figure 1) . Hepatic tissue samples were taken for a PCR of HSV-1 and HSV-2 with seropositive results based for HSV 2. An infusion of acyclovir was started and continued for 21 days, which led to swift improvement of symptomatology and significant decrease of liver enzymes.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
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| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |