Fatal fulminant herpes simplex hepatitis following surgery in an adult

Table 1 Reported cases of herpes simplex virus hepatitis in patients underwent non-transplant surgical procedures

No. authors (year), (reference)	Age (yr), sex/ races or nationality	Surgical procedures (diseases)/transmission pathway	Manifestation (days after surgery )/herpetiform lesions	Laboratory data Leucocytes (/mm3), Platelets (× 104/mm3), AST/ALT (U/L), TB (mg/dL). Coagulopathy, encephalopathy	HSV serology (IgM/ IgG), HSV type, HSV PCR	Ante-mortem diagnosis/ methods	Treatment/outcome (survival time after surgery, time after onset of liver dysfunction)
1.Douglas (1977)[33]	17, M/ United States	Splenectomy, liver biopsy, Ln excision (remission of Hodgekin’s disease)/ND	Fever (day 3), vomiting and diarrhea (day 4), liver dysfunction (day 5)/ none	ND, ND, 8700/ND, ND	ND/ND, ND, ND	No/ autopsy	Supportive/died (11 d, 6 d)
2. Marrie (1982)[34],	28, M/ white, Canada	Drainage, steroids (Brain stem injury)/ ND	Fever(12 HD)/ tongue, palate (20HD, 6 pod)	ND, ND, 9000/7000, ND. Encepahopathy	ND/ND, HSV-1, ND	No/liver biopsy	Spontaneously improved
3. Williams (1985)[35]	57, M/ United States	Aorto-coronary bypass, PSL (postcardiotomy syndrome)/esophagitis	Nausea, weakness, epigastric discomfort, liver dysfunction (day 8)/ none	ND, ND, 10050/4905, ND. Coagulopathy	ND/ND, HSV, ND	No/ autopsy	Supportive/died (10 d, 2 d)
4. Fisher (1985)[36]	62, M/ United States	Transperitoneal ureteroithotomy and cholecystectomy (ureteral obstruction and cholelithiasis)/ ND	Fever (day 3), vomiting (day 6), diarrhea (day 9), liver dysfunction (day 9)/ none	5600, 8.1, > 500/ND, 1.2, Coagulopathy, Encephalopathy	ND/ND, HSV-1, ND	No/ autopsy	Supportive/died (14 d, 5 d)
5-7, Goodman (1986)[8]	81, F/ United States	Gastrectomy (stomach cancer)/ ND	Fever (day 8)/ ND	ND	ND/ND, ND, ND	No/ autopsy	Supportive/died (ND, 6 d)
	93, F/ United States	Biliary bypass (bile duct cancer)/ ND	ND/ ND	ND	ND/ND, ND, ND	No/ autopsy	Supportive/died (ND, 16 d)
	59, M/ United States	PD (bile duct cancer ) stormy course /ND	ND/ ND	ND	ND/ND, ND, ND	No/ autopsy	Supportive/died (ND, 30 d)2
8. Katz (1994)[37]	76, M/ United States	Hemimandibulectomy, radical neck, and tracheotomy (plasmacytoma)/ND	Fever (day 6), diarrhea (day 9), liver dysfunction (day 11)/ none	10100, ND, 7460/2970, ND. Coagulopathy, Encephalopathy	ND/ND, ND, ND	No/ autopsy	Supportive/died (15 d, 4 d)
9. Kaufman (1997)[38]	66, M/ United States	Tumor excision, intraoperative PSL (menigioma)/ ND	Fever (day 14), liver dysfunction (day 20), lethargic (day 20)/ mo	4800, 2, 10340/ND, 1.9. Coagulopathy, Encephalopathy	ND/ND, HSV-1, ND	No/autopsy	Supportive/died (21 d, 1 d)
10. Price (2001)[39]	Nulliparous/ United States	Laparoscopy, hysteroscopy (tubal infertility)/genital tract	Fever, nausea, abd pain, vaginal burning (day 3) /none	900, ND, ND/ND, ND. Coagulopathy	-/-, HSV-1, ND	No/autopsy	Supportive/died (9 days, 6 d)
11. Kohno (2001)[40]	58, M/ Japanese	Craniotomy (hypertensive cerebral hemorrhage)/ ND	Liver dysfunction (day 7)/none	11100, 9.3, 10956/5327, 3.5. Coagulopathy, Encephalopathy	ND/ND, HSV-2, ND	No/autopsy	Supportive/died (16 d, 9 d)
12. Ichai (2005)[20]	15 F/ France	Craniotomy (brain tumor) , PSL/ ND	Fever (day 9), Liver dysfunction (day 12)/ none	9000, ND, 5000/ 4500, ND	+/+, HSV-2, PCR positive	Yes/serology, explanted liver culture	LT/ died (CR l yr)
13. Biancofiore (2007)[41]	25, M/ Italy	Thymectomy (myasthenia gravis)/ND	Fever (day 2), liver dysfunction (day 10)/	7820, 3.8, 15000/6818, 2.1. Encephalopathy	-/-, HSV-1, PCR positive	Yes/PCR (urine, blood, cerebrospinal fluid)	ACV (day 10) , LT (d 12)/died (12 d, 9 d after LT)
14. Chaudhary (2017)[42]	48 F/ Hispanic, United States	Repair of vaginal cuff (Vaginal cuff dehiscence/ trans-vaginal	liver dysfunction (day 1)/ vaginal ulcers	ND, ND, 20692/63, 8.5. Encephalopathy	+/-, HSV-2, PCR (serum, cerebrospinal fuid)	Yes/ vaginal ulcers, serology, PCR	ACV (day 4), foscarnet (day 10)/ survived
15. Present case	72, M/ Japanese	cholecystectomy and choledocholithotomy (biliary stone)/ ND	Fever (day 5), diarrhea (day 5), liver dysfunction (day 5)/ none	1200, 4.3, 6557/2039, 2.0. Coagulopathy, Encephalopathy	-/-, HSV-1, ND	No/ autopsyr	ACV (day 8)/died (9 d, 4 d)
Summary	58 yr (15-93)/Male (n = 8), United States (n = 10), Japan (n = 2), Canada (n = 1), France (n = 1), Italy (n = 1)	Malignancy (n = 5), benign (n = 10), Immunosuppressive status or treatment (n = 5)/ surgical wound (n = 2), trans-esophagus (n = 1)	Fever: (n = 15), day 4.5 (day 1-14), Digestive symptoms (n = 6): day 7 (day 4-9), Liver dysfunction (n = 15) day 8.5 (day 1-20)/ Herpetiform lesions: present (3/11 cases)	Leukocytes: 3.905 (900-10100), Plts: 4.3 (2-8.1), AST/ALT: 10.340 (5000-20692)/5116 (2970-7000), TB: 2.1 (2-8.5). Coagulopathy (n = 8), Encephalopathy (n = 7)	IgM +/- (2/3 cases)/ IgG +/- (1/4 cases), HSV: type-1(n = 5), type-2 (n = 3), PCR (n = 3)	Yes/no: 3/12 cases, Autopsy (n = 12), biopsy (n = 1), PCR (n = 3), serology (n = 1),	Supportive (n = 10), ACV (n = 3), LT (n = 2)/ Outcome: survived (n = 2), died (n = 13), Survival time1 after surgery: 13 (6-30) d, Survival time after liver dysfunction: 5.5 (1-9) d

The continuous data were expressed as median values (minimum-maximum values).

¹Survival time: Data were excluded those of surviving patients;

²The patient was co-infected with multiple agents; bacteria and fungi in the abdominal abscess, cytomegalovirus in the pancreas and lungs, and HSV in the lung and liver. Abd: Abdominal; ACV: Acyclovir; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; CR: Chronic rejection; HD: Hospital day; HSV: Herpes simplex virus; Ln: Lymph node; LT: Liver transplantation; ND: Not determined or described; PCR: Polymerase chain reaction; POD: Postoperative days; PSL: Predonisolone; TB: Total bilirubin.