Abstract
Herpes simplex viruses (HSV) are ubiquitous and produce a wide array of illnesses, most commonly causing mucocutaneous infections, and are occasionally associated with dissemination to visceral organs. Hepatitis due to HSV infection is a rare but frequent cause of fulminant hepatitis in immunocompromised patients, pregnancy, and newborns. In this article, we describe an unusual case of fulminant HSV hepatitis in a patient shortly after receiving a short course of corticosteroids and a concomitant undiagnosed renal cell carcinoma with a fatal outcome. An autopsy examination revealed massive hepatic necrosis and in situ hybridization on liver tissue was positive for HSV. Given the potential for cure, prompt diagnosis via transjugular biopsy should be undertaken and empiric treatment with acyclovir of nonacetaminophen-induced fulminant hepatitis should be evaluated.
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