Fulminant hepatic failure due to herpes simplex after hysteroscopy.

Abstract

Fulminant hepatic failure due to herpes simplex in healthy adults is a rare condition with a high mortality rate. The lack of specific symptoms and the absence of typical herpetic lesions in a majority of cases contribute to delayed diagnosis. We describe a fatal case of fulminant hepatic failure due to herpes simplex in a healthy woman presenting after laparoscopy and hysteroscopy for tubal infertility. The patient lacked evidence of mucocutaneous lesions or jaundice. The surgery likely contributed to viral dissemination. Although rare, disseminated herpes should be considered a possible cause of postsurgical pelvic infections, even in the absence of ulcerative lesions. Until a definitive diagnosis is made, antiviral therapy should be considered in patients with high fever, leukopenia, and abnormal liver function.