• Rev Med Interne · Dec 2014

    Case Reports

    [Herpes simplex hepatitis with macrophage activation syndrome in an immunocompetent patient].

    • M Mihalcea-Danciu, B Ellero, M Gandoin, M-L Harlay, F Schneider, and P Bilbault.
    • Service des urgences médico-chirurgicales adultes, hôpital de Hautepierre, CHU, 1, avenue de Molière, 67098 Strasbourg cedex, France. Electronic address: mihalcea78@yahoo.com.
    • Rev Med Interne. 2014 Dec 1; 35 (12): 823-6.

    IntroductionHerpes simplex hepatitis is a rare cause of acute hepatitis in immunocompetent patients. The triad of fever, increase in liver enzymes and leucopenia is suggestive of herpes simplex hepatitis. Delayed diagnosis without antiviral therapy contributes significantly to an unfavorable outcome.ObservationWe report a 50-year old immunocompetent male patient, who presented with acute severe hepatitis due to a reactivation of a herpes simplex infection with a complicated course including macrophage activation syndrome and severe coagulopathy. Outcome was finally favorable with early acyclovir therapy.ConclusionDespite its relatively low occurrence rate, diagnosis of herpetic hepatitis should be discussed in immunocompetent patients with acute liver failure. The benefit of an early acyclovir treatment should lead clinicians to consider this uncommon diagnosis in unexplained cases of hepatitis and to test rapidly HSV DNA levels by PCR in plasma.Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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