Fulminant hepatic failure due to herpes simplex after hysteroscopy

BACKGROUND: Fulminant hepatic failure due to herpes simplex in healthy adul ts is a rare condition with a high mortality rate. The lack of specific sym ptoms and the absence of typical herpetic lesions in a majority of cases co ntribute to delayed diagnosis. CASE We describe a fatal case of fulminant hepatic failure due to herpes si mplex 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. CONCLUSION: Although rare, disseminated herpes should be considered a possi ble cause of postsurgical pelvic infections, even in the absence of ulcerat ive lesions. Until a definitive diagnosis is made, antiviral therapy should be considered in patients with high fever, leukopenia, and abnormal liver function. (Obstet Gynecol 2001;98: 954-6. (C) 2001 by the American College of Obstetricians and Gynecologists.).