Case report: Benefits of quantitative polymerase chain reaction in the clinical management of herpes simplex virus 1 infection with prominent hepatitis and unusual secondary progression

• Published in: Journal of medical virology 2012-03, Vol.84 (3), p.457-461
• Main Authors: Chaillon, Antoine, Schnepf, Nathalie, Jonas, Maud, Mondon, Karl, Orain, Isabelle, Lioger, Bertrand, Cottier, Jean-Philippe, Hommet, Caroline, Goudeau, Alain
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Antibodies, Viral - blood; Antibodies, Viral - immunology; autoimmunity; Biological and medical sciences; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - diagnosis; Coinfection; Disease Progression; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Hepatitis, Viral, Human - diagnosis; Hepatitis, Viral, Human - drug therapy; Herpes Simplex - diagnosis; Herpes Simplex - drug therapy; herpes simplex virus; Herpes simplex virus 1; Herpesvirus 1, Human - genetics; Herpesvirus 1, Human - immunology; Herpesvirus 1, Human - isolation & purification; Human viral diseases; Humans; Infectious diseases; Liver - pathology; Liver - virology; Magnetic Resonance Imaging; Medical sciences; Meningitis, Aseptic - diagnosis; Meningitis, Aseptic - etiology; Microbiology; Miscellaneous; quantitative PCR; Real-Time Polymerase Chain Reaction; vasculitis; Viral diseases; Virology
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.23230

Herpes simplex virus (HSV) infection is rarely considered in the differential diagnosis of severe acute hepatitis and disseminated infection in immunocompetent adults. A case of disseminated HSV‐1 infection in an 82‐year‐old woman initially presenting with neurological problems, signs of meningitis and prominent hepatitis was investigated. Initial diagnosis, monitoring, and follow‐up were based on the application of molecular methods to cerebrospinal fluid, serum, and liver tissue samples from this patient. Following an initial full recovery, the patient presented delayed intracerebral haemorrhage and diffuse arthralgia. This atypical case, with delayed secondary progression, highlights the wide range of clinical features of HSV infection and the benefits of monitoring viral load by quantitative real‐time polymerase chain reaction (PCR) during patient management. J. Med. Virol. 84:457–461, 2012. © 2011 Wiley Periodicals, Inc.