Herpes simplex virus colitis mimicking acute severe ulcerative colitis: a case report and review of the literature

Abstract

A 60-year-old female patient with longstanding left-sided ulcerative colitis presented with symptoms mimicking an acute flare and developed a colonic perforation shortly after starting steroid treatment. Following left hemicolectomy and Hartmann’s procedure, rescue treatment with infliximab was started. Within a few days, the patient developed hepatic failure. Histology and immunohistochemistry of the specimen revealed extensive necrotizing herpes simplex virus colitis, and liver biopsy demonstrated herpes simplex virus hepatitis. Sixteen days after admission, the patient died from multiorgan failure. This compelling case of severe herpes simplex virus colitis raises awareness of a rare but potentially detrimental infection in patients with inflammatory bowel disease.

The Scope and Impact of Viral Infections in Common Variable Immunodeficiency (CVID) and CVID-like Disorders: A Literature Review

“…HSV colitis is a rare complication, sometimes seen complicating IBD in the context of immunosuppression, though there are fewer than 10 reported cases of this in the English literature [ 174 , 175 ]. Within this cohort, all HSV colitis cases present as acute severe UC, with subsequent colectomies, and sometimes delayed virological diagnosis [ 175 ]. There have been previous reports of successful treatment with the antiviral aciclovir [ 174 ].…”

A Rare Case of Herpes Simplex Virus and Cytomegalovirus Dual Infection Inducing Unremitting Ulcerative Colitis

“…Herpes simplex virus (HSV-1 or HSV-2) infection is less commonly reported in IBD patients and has a less clear role in UC flares [14]. However, chronic inflammation and immunosuppressive agents such as corticosteroids, azathioprine, and mesalamine are known to cause increased infection risk [15].…”