A case report of severe systemic herpes simplex virus-1 (HSV-1) infection with multi-organ involvement after a course of oral corticosteroid treatment

Abstract

Background Herpes simplex virus (HSV) rarely causes organ-invasive infection. Diagnosis and treatment for such infections are often delayed, and mortality is high. We present the first reported case of disseminated HSV-1 infection in an adult causing liver failure, myocarditis, and encephalitis in a patient who recovered after receiving parenteral acyclovir treatment. Case presentation A 46-year-old female presented with fever, chills, and malaise after 2 weeks of oral corticosteroid treatment for uveitis. She was diagnosed with disseminated HSV-1 infection with multi-organ involvement causing hepatitis, encephalitis, and myocarditis. Diagnosis was made timely using serum polymerase chain reaction (PCR) for HSV DNA and the patient was given intravenous acyclovir treatment promptly, which led to her survival without significant morbidity. Conclusions Clinicians should have a low threshold for suspecting HSV infection and ordering HSV PCR to decrease morbidity and mortality when there is a high clinical suspicion of systemic HSV infection with multi-organ involvement. Serum PCR for HSV DNA is an excellent modality for an initial diagnostic approach. Further research is warranted to elucidate causality between a course of corticosteroid therapy and systemic HSV-1 infection without major immunosuppressive comorbidities or treatments.

Sepsis and multi-organ failure due to genital herpes in a healthy person

“…[2][3][4] Sepsis or disseminated infection due to HSV-2 is one of the most severe forms of HSV-associated disease with a high mortality rate and has been only rarely reported in immunocompromised, neonatal, or pregnant women. 5,6 The present patient was a young adult male who was previously in good health, side by side reflecting the rarity of this case. In neonatal sepsis, HSV is the most common viral cause 7 and HSV-2 accounts for a high proportion of disseminated HSV disease.…”

Enhanced Anti-Herpetic Activity of Valacyclovir Loaded in Sulfobutyl-ether-β-cyclodextrin-decorated Chitosan Nanodroplets

“…A relevant feature of these pathogens is the establishment a lifelong latent infection in neuronal cells that innervate the infected epithelium and periodical reactivation following various environmental cues. Genital herpes can cause severe or fatal infection in newborns through vertical congenital transmission from the mother to the infant [5,6] and can lead to severe complications in immunocompromised patients [7][8][9]. Of note, HSV-2 is strongly correlated to HIV infections [10,11].…”