Herpes simplex viruses (HSVs) are the most common cause of mucocutaneous infections with dissemination to visceral organs. HSV-induced hepatitis is a rare but frequent cause of hepatitis in immunocompromised patients, pregnant women, and newborns. However, diagnosis is often difficult because the clinical features are nonspecific. In addition, the HSV-related mortality rate is high. Signs and symptoms of HSV include fever, anorexia, nausea, vomiting, abdominal pain or tenderness, leukocytopenia, coagulopathy, and an increase in serum transaminase levels without jaundice. We present a patient who did not correspond to the above symptoms, but survived following prompt intravenous high-dose acyclovir provided early in the course of the disease.

Citations

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• A Surprising Cause of Liver Abscesses in a Post-Chemotherapy Patient: Herpes Simplex Virus
  Rukevwe Ehwarieme , Apeksha N Agarwal, Rahaf Alkhateb , Jason E Bowling, Gregory M Anstead
  Cureus.2021;[Epub]     CrossRef
• Herpes hepatitis as a complication of total abdominal hysterectomy; an unusual complication of abdominal instrumentation
  Muharrem Yunce, Pavan Bhat, Daisy Jaganathan, Michelle Bahrain
  Clinical Case Reports.2019; 7(1): 11.     CrossRef
• A Rare Case of Herpes Simplex Virus-2 Hepatitis with Negative Serology
  Mohanad Soliman, Olalekan Akanbi, Ihab Almagdub, Kishore Karri, Pradeep Yarra, Saad Emhmed Ali, Hanine El Haddad
  Case Reports in Hepatology.2019; 2019: 1.     CrossRef

Spontaneous pneumomediastinum is an uncommon disease that is defined as the presence of free air in the mediastinum in the absence of any obvious precipitating cause. This condition occurs as a rare complication of acute exacerbation of asthma. Classic symptoms include retrosternal chest pain, dyspnea and cough, but are not specific. Spontaneous pneumomediastinum complicated by asthma is usually self-limiting and well controlled with conservative management, but this condition can be potentially life threatening. We report a case of 18-year-old woman with asthma who presented with spontaneous pneumomediastinum. The patient was treated conservatively with oxygen and steroid therapy, and her clinical conditions were improved. Spontaneous pneumomediastinum disappeared.

Splanchnic vein thrombosis arising from complications of acute pancreatitis is very rare. It usually occurs as a form of portal, splenic and superior mesenteric vein thrombosis, either in combination or separately. It could develop portal hypertension, bowel ischemia and gastrointestinal variceal bleeding. Treatment of splanchnic vein thrombosis includes anticoagulants, thrombolysis, insertion of shunts, bypass surgery and liver transplantation. In some cases, anticoagulation therapy may be considered to prevent complications. However, the standard protocol for anticoagulation in splanchnic vein thrombosis has not been determined yet. We report a case of 43-year-old man who had portal and splenic vein thrombosis in acute pancreatitis. The patient was successfully treated with oral anticoagulants following low molecular weight heparin therapy.

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• Current practice of anticoagulant in the treatment of splanchnic vein thrombosis secondary to acute pancreatitis
  William Norton, Gabija Lazaraviciute, George Ramsay, Irene Kreis, Irfan Ahmed, Mohamed Bekheit
  Hepatobiliary & Pancreatic Diseases International.2020; 19(2): 116.     CrossRef