Ngo Dallis Q, Vu Christina, Mdluli Xolani, Platt Katrina, Asgeri Mehrdad
Pulmonary Medicine, Saint Peter's University Hospital, New Brunswick, USA.
Infectious Diseases, University of Southern California, Los Angeles, USA.
Cureus. 2020 Aug 3;12(8):e9529. doi: 10.7759/cureus.9529.
We present a rare case of a healthy, non-pregnant, middle-aged and immunocompetent woman who underwent laparoscopic cholecystectomy for acute cholecystitis with a post-operative course complicated by herpes simplex virus type 1 (HSV-1) hepatitis secondary to post-surgical inflammation. Her initial post-operative course was complicated by intermittent fevers, leukocytosis, jaundice, elevated transaminases, and right upper quadrant abdominal pain, and she was subsequently placed on broad-spectrum antibiotics with no improvement. During her hospital course, the patient developed herpes labialis, and HSV-1 hepatitis was confirmed by serology and HSV-1 polymerase chain reaction (PCR), in lieu of a liver biopsy. After this was discovered, the patient was placed on valacyclovir and had a successful response. The importance of this case is to emphasize the possibility of herpes simplex virus (HSV) hepatitis as a post-operative complication and the benefit of early empiric antiviral treatment.
我们报告了一例罕见病例，患者为一名健康、未孕、中年且免疫功能正常的女性，因急性胆囊炎接受了腹腔镜胆囊切除术，术后病程因手术炎症继发单纯疱疹病毒1型（HSV-1）肝炎而变得复杂。她术后初期病程出现间歇性发热、白细胞增多、黄疸、转氨酶升高及右上腹疼痛，随后接受广谱抗生素治疗但无改善。在住院期间，患者出现唇疱疹，通过血清学和HSV-1聚合酶链反应（PCR）确诊为HSV-1肝炎，未进行肝活检。发现此情况后，患者接受伐昔洛韦治疗并取得成功疗效。该病例的重要性在于强调单纯疱疹病毒（HSV）肝炎作为术后并发症的可能性以及早期经验性抗病毒治疗的益处。
