Fulminant herpes hepatitis in a healthy adult - A treatable disorder?

Hepatitis due to herpes simplex virus (HSV) is a potentially fatal disorder that is often not considered in the differential diagnosis of acute hepati tis. This disease occurs most often in patients with impaired immunity and is very uncommon in healthy patients. HSV hepatitis presents with a wide cl inical spectrum, and the clinical diagnosis is difficult. We describe a cas e of disseminated herpes virus infection with fulminant hepatitis mimicking an acute human immunodeficiency virus infection in a 33-year-old healthy m an. Preliminary studies suggest that early treatment of HSV hepatitis with acyclovir may be beneficial in these patients. A high index of suspicion an d the availability of early diagnostic tools, such as HSV DNA detection, ma y dramatically improve the clinical outcome of severe HSV hepatitis.