Chaudhary Dhruv, Ahmed Shifat, Liu Nanlong, Marsano-Obando Luis
Department of Internal Medicine, University of Louisville, Louisville, KY.
Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY.
ACG Case Rep J. 2017 Feb 15;4:e23. doi: 10.14309/crj.2017.23. eCollection 2017.
Herpes simplex virus (HSV) hepatitis is a rare cause of acute liver failure (ALF). It carries a mortality rate of 80% if untreated, thus early identification and treatment are critical. Without high clinical suspicion, HSV hepatitis is difficult to diagnose. A 48-year-old Hispanic female presented with a 4-day history of abdominal pain and a vaginal cuff tear requiring laparoscopic repair. She subsequently developed postsurgical disseminated HSV, resulting in ALF. Acyclovir was initiated, but she was resistant to treatment. She was given additional foscarnet and responded without requiring a liver transplant.
单纯疱疹病毒（HSV）肝炎是急性肝衰竭（ALF）的罕见病因。若不治疗，其死亡率达80%，因此早期识别和治疗至关重要。若无高度临床怀疑，HSV肝炎很难诊断。一名48岁西班牙裔女性因腹痛4天及阴道断端撕裂需行腹腔镜修补术就诊。她随后发生术后播散性HSV感染，导致急性肝衰竭。开始使用阿昔洛韦治疗，但她对治疗耐药。给予其膦甲酸钠后病情好转，无需进行肝移植。
