Fatal herpes simplex virus hepatitis in a patient with esophageal cancer under radiochemotherapy

Grimm, Birgit and Padberg, Barbara and Ruhstaller, Thomas and Fleisch, Felix and von Moos, Roger. (2008) Fatal herpes simplex virus hepatitis in a patient with esophageal cancer under radiochemotherapy. Onkologie, 31 (11). pp. 620-622.

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Official URL: http://edoc.unibas.ch/dok/A6005626

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BACKGROUND: Herpes simplex virus (HSV) infections are frequent. However, HSV hepatitis is rare and may lead to a life-threatening condition. CASE REPORT: A 68-year-old patient with a locally advanced and inoperable esophageal carcinoma was treated with induction chemotherapy and combined chemoradiation. After a total of 9 weeks of treatment, he developed fulminant liver failure of unknown origin and died a few days later. Surprisingly, the post mortem examination revealed an HSV infection of the esophagus and an HSV-associated necrotisizing hepatitis. CONCLUSION: In this immunocompromised patient, we postulate an HSV-associated esophagitis that led to viremia and fulminant hepatitis. Especially in immunocompromised hosts, HSV hepatitis should be considered in the differential diagnosis in patients with anicteric hepatitis and marked elevation of transaminases. A liver biopsy is the quickest and most definitive diagnostic tool to diagnose HSV hepatitis. If this is not possible because of severe coagulopathy, polymerase chain reaction for HSV DNA should be performed. Awaiting diagnosis, a prompt empirical treatment with acyclovir has to be discussed in case of a characteristic biochemical profile.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Onkologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Onkologie
UniBasel Contributors:Ruhstaller, Thomas
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Karger Publishers
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 Oct 2017 09:51
Deposited On:11 Oct 2012 15:29

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