Herpes simplex-induced fulminant hepatitis in adults a call for empiric therapy

David J. Peters, Wallace Greene, Francesca Ruggiero, Thomas McGarrity

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


Herpes simplex-induced fulminant hepatitis is an infrequently reported cause of hepatitis in adults. Pregnant females and patients with impaired cellular immunity may be at increased risk, although healthy adults have been affected. The diagnosis may be underrecognized due to nonspecific presenting symptoms and lack of typical cutaneous herpes lesions. We present three cases of fatal herpes simplex fulminant hepatitis. Our review of case reports of herpes simplex hepatitis in adults demonstrates improved survival with intravenous acyclovir therapy. We believe that empiric use of acyclovir should be considered while the diagnostic evaluation of non-acetaminophen-induced fulminant hepatitis is underway. Recognition of characteristic liver function abnormalities seen with fulminant herpes simplex hepatitis include marked elevation of transaminases with AST > ALT and a mild hyperbilirubinemia (anicteric hepatitis), and they should prompt acyclovir therapy. This is especially true when there are no obvious risk factors for other forms of hepatitis.

Original languageEnglish (US)
Article number298163
Pages (from-to)2399-2404
Number of pages6
JournalDigestive Diseases and Sciences
Issue number12
StatePublished - 2000

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology


Dive into the research topics of 'Herpes simplex-induced fulminant hepatitis in adults a call for empiric therapy'. Together they form a unique fingerprint.

Cite this