Clinical Infection in Practice最新文献

{"title":"WHO-classified COVID-19 ‘variant of interest’ JN.1: A community health concern in the winter and festive season","authors":"Ranjan K. Mohapatra , L.V. Simhachalam Kutikuppala , Snehasish Mishra , Ashish K. Sarangi , Lawrence Sena Tuglo","doi":"10.1016/j.clinpr.2024.100348","DOIUrl":"10.1016/j.clinpr.2024.100348","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170224000086/pdfft?md5=d822f1ac2b6050ab123210eb0784adb7&pid=1-s2.0-S2590170224000086-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of ceftriaxone-induced immune haemolytic anaemia in an ambulatory care setting","authors":"Rakhee Mistry ,&nbsp;Luke S.P. Moore ,&nbsp;Nabeela Mughal ,&nbsp;Andrew Godfrey ,&nbsp;Stephen Hughes","doi":"10.1016/j.clinpr.2024.100341","DOIUrl":"10.1016/j.clinpr.2024.100341","url":null,"abstract":"<div><h3>Background</h3><p>Drug-induced immune haemolytic anaemia (DIIHA) is a rare adverse effect which varies between mild to fatal (<span>Garratty, 2010</span>). One of the most common class of drugs reported to cause severe DIIHA are the second and third generation cephalosporins (e.g. ceftriaxone) (<span>Garratty, 2010</span>, <span>Hill et al., 2017</span>).</p><p>We report an event of severe, life-threatening DIIHA caused by ceftriaxone administered in an ambulatory setting to a patient via Outpatient Parenteral Antimicrobial Therapy (OPAT) service and our subsequent management of the adverse reaction.</p></div><div><h3>Case report</h3><p>A 60-year old male was referred to the OPAT service for radiologically-confirmed osteomyelitis. He was commenced on ceftriaxone 4 g daily intravenous infusions in the ambulatory care unit. Shortly after receiving the ninth dose, he became acutely pale, tachycardic, tachypnoeic, and hypotensive with multiple witnessed syncopal episodes inside the unit. Haemoglobin level fell to &lt;30 g/L on blood gas and on formal laboratory analysis (Abbott® Alinity) 39 g/L (from baseline of 97 g/L). No obvious source of bleeding was identified which suggested an acute haemolytic process.</p><p>Management included high-dose corticosteroids and a single dose of intravenous immunoglobulin. Ceftriaxone was immediately discontinued and a beta-lactam free regimen was commenced. Haemoglobin level improved within 24 h with a gradual return to baseline within seven days.</p></div><div><h3>Conclusions</h3><p>Our case highlights the need for ambulatory care and OPAT teams to be aware of this rare, idiosyncratic adverse reaction which may occur in otherwise clinically stable patients. We advocate weekly haematological monitoring in OPAT patients.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100341"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170224000013/pdfft?md5=057d678ff87aa25893bfe0f8b7ea90b9&pid=1-s2.0-S2590170224000013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nipah virus encephalitis: Neurological consequences of a zoonotic disease","authors":"Prakasini Satapathy,&nbsp;Vinay Suresh,&nbsp;Ahmad Neyazi,&nbsp;Sarvesh Rustagi ,&nbsp;Ranjit Sah ,&nbsp;Bijaya Kumar Padhi","doi":"10.1016/j.clinpr.2023.100339","DOIUrl":"https://doi.org/10.1016/j.clinpr.2023.100339","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100339"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259017022300122X/pdfft?md5=206de5b64cca1a186052885ba18f21b4&pid=1-s2.0-S259017022300122X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138839049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antineutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis following COVID-19 BBIBP-CorV vaccine: A case report","authors":"Parisa Javadian ,&nbsp;Negin Fadaei-Tirani ,&nbsp;Zainab Amoosoltani-Forooshani ,&nbsp;Vahid Reisi-Vanani ,&nbsp;Mina Borran","doi":"10.1016/j.clinpr.2023.100337","DOIUrl":"https://doi.org/10.1016/j.clinpr.2023.100337","url":null,"abstract":"<div><p>COVID-19 and its vaccination could initiate autoimmunity including ANCA-associated vasculitis that could mimic COVID-19 infection symptoms. This misdiagnosis could increase the morbidity of AAV. Herein a case of AAV post-BBIBP-CorV (Sinopharm) COVID-19 vaccine was reported. A 32-years-old woman was admitted with flu-like symptoms, flank pain, hemoptysis, hematuria, and oliguria following the second dose of BBIBP-CorV vaccination. Due to her severe clinical course, she needed ICU care while plasma exchange, renal replacement therapy, corticosteroid pulse, and tocilizumab were the primary therapies that improved her symptoms. After more evaluation, she was diagnosed with AAV, and conservative therapy was initiated. Her pulmonary condition and renal function were resolved gradually. Reports of post-COVID-19 vaccination raised the need for assessment of the immune response caused by these vaccines. Physicians also should be aware of the misdiagnosis of AAV and other infectious diseases.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100337"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170223001206/pdfft?md5=494e344a021d2f09f42668e27b87b95e&pid=1-s2.0-S2590170223001206-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138713255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enterococcus faecalis bacteraemia and infective endocarditis - what are we missing?","authors":"Clemency Nye ,&nbsp;Alice Maxwell ,&nbsp;Harriet Hughes ,&nbsp;Jonathan Underwood","doi":"10.1016/j.clinpr.2023.100336","DOIUrl":"10.1016/j.clinpr.2023.100336","url":null,"abstract":"<div><h3>Introduction</h3><p><em>Enterococcus faecalis</em> is an increasingly common cause of infective endocarditis, with a recent study by Dahl <em>et al</em> demonstrating a prevalence of 26% of IE when transoesophageal echo was routinely undertaken. Another study undertaken by Østergaard <em>et al</em> found that 16.7% of patients with <em>E. faecalis</em> bacteraemia developed endocarditis. Based on these findings we examined the rates of IE diagnosed in our own health board to determine if our current practice is potentially missing cases of IE and if we could improve our management of these bacteraemias.</p></div><div><h3>Methods</h3><p>All blood cultures in patients over 18 which were positive for <em>E. faecalis</em> from October 2017 to March 2022 were reviewed. We analysed the patient characteristics, clinical outcomes and included a follow up period of 6 months to assess for recrudescence and treatment failure.</p></div><div><h3>Results</h3><p>The rate of patients with <em>E. faecalis</em> bacteraemia diagnosed with IE was 7.1%. If polymicrobial blood cultures were excluded this rose to 13.0%. Community acquisition, patient cardiac or immune risk factors, monomicrobial culture and multiple positive blood cultures all were associated with IE. 62.1% of patients with <em>E. faecalis</em> bacteraemia did not have an echocardiogram during their admission, due to a variety of reasons.</p></div><div><h3>Discussion</h3><p>The lower reported rate of IE in our cohort may be explained by higher proportion of CVC related infections. However, given the low rates of echocardiography and poor correlation of echocardiography use with IE risk factors, it is likely that cases of IE are being missed, particularly in those with multiple risk factors. Despite this, there was no difference in one-year survival between those diagnosed with IE vs without IE. We have delivered education sessions and introduced a multidisciplinary team meeting to discuss infective endocarditis cases to address these issues.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100336"},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259017022300119X/pdfft?md5=8b8c222fd93dbc40eb3b4d3dd7b756ba&pid=1-s2.0-S259017022300119X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138608604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spondylodiscitis complicated with an epidural abscess due to Shewanella Algae: A case report","authors":"E.M. Nassafi ,&nbsp;V. Remiche ,&nbsp;A. Ionicioiu ,&nbsp;M. Delvallee","doi":"10.1016/j.clinpr.2023.100338","DOIUrl":"https://doi.org/10.1016/j.clinpr.2023.100338","url":null,"abstract":"<div><p>The presented case report concerns a 40-years-old man who was admitted to the infectiology department for back pain and elevated C-reactive protein, leading to suspicion of spondylodiscitis. Initially, the first lumbar spine MRI yielded negative results. Nevertheless, the patient was treated with Gentamicin followed by Ceftriaxone and Levofloxacin for a sepsis to Shewanella Algae. The second lumbar spine MRI on day 8 confirmed the diagnosis.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100338"},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170223001218/pdfft?md5=477e86e76ca2035a1f86f3e658981c9c&pid=1-s2.0-S2590170223001218-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138582087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parvovirus B19 induced acute severe anaemia in a well-controlled HIV-positive individual","authors":"Thomas Swaine,&nbsp;Niall Ahmad,&nbsp;Aula Abbara,&nbsp;Borja Mora-Peris,&nbsp;Melissa Wickremasinghe,&nbsp;Christopher Lambert,&nbsp;Anas Khan,&nbsp;Paul Randell","doi":"10.1016/j.clinpr.2023.100334","DOIUrl":"10.1016/j.clinpr.2023.100334","url":null,"abstract":"<div><h3>Background</h3><p>We describe the unusual case of a parvovirus B19 (PB19) infection inducing a severe acute aplastic anaemia with secondary multiorgan dysfunction in the context of well-controlled HIV and the absence of an underlying chronic haemolytic disorder. Treatment with intravenous immunoglobulin therapy (IVIG) was also required in this case due to persisting reticulocytopaenia, seemingly at odds with established descriptions of PB19 related anaemic syndromes as either chronic Pure Red Cell Aplasia or acute Transient Aplastic Crises.</p></div><div><h3>Case presentation</h3><p>A 25-year-old Brazilian male tourist living with well-controlled HIV and undetectable HIV viral load presented in extremis with multiorgan dysfunction after a 5-day history of non-specific illness. Investigation for PB19 confirmed a positive IgM, weakly positive IgG, and significant PB19 viraemia. He received initial supportive management with blood products and was later given two doses of 1 g/kg immunoglobulin therapy for persistent reticulocytopaenia. He was able to be discharged to his country of origin and reported no subsequent relapse at follow up at one year.</p></div><div><h3>Conclusions</h3><p>Severe PB19 infections remain a rare but significant phenomenon amongst patients living with HIV even in the context of adherence to effective antiretroviral therapy, and it appears hyperacute presentations are possible even without underlying chronic haemolytic disorders. Though there is a dearth of contemporary practice managing these infections, treatment with IVIG remains a cornerstone therapy in these instances where ART alone is not sufficient to resolve reticulocytopaenia.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100334"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170223001176/pdfft?md5=a0e1f23a34cd416064753e588c83656b&pid=1-s2.0-S2590170223001176-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first reported case of human infection with Variovorax durovernensis; a novel Variovorax sp. Isolated from the prosthetic aortic graft of a shepherd","authors":"Lara Payne ,&nbsp;Adela Alcolea-Medina ,&nbsp;Luke B Snell ,&nbsp;Christopher Alder ,&nbsp;Themoula Charalampous ,&nbsp;Jake D Turnbull ,&nbsp;Jonathan D Edgeworth ,&nbsp;Rahul Batra ,&nbsp;John L Klein ,&nbsp;Anna L Goodman","doi":"10.1016/j.clinpr.2023.100332","DOIUrl":"10.1016/j.clinpr.2023.100332","url":null,"abstract":"<div><h3>Background</h3><p>We describe a case of a 55-year-old shepherd with history of mycotic aneurysm presenting with a chronic aortic endovascular graft infection caused by <em>Nocardia nova</em> and a newly identified <em>Variovorax sp</em> which we named ‘<em>Variovorax durovernensis</em>’. This is the first case of this <em>Variovorax sp</em>. causing human pathology. This organism was identified with whole-genome sequencing as a new species of <em>Variovorax</em>, with ‘Durovernum’ (the Latin name for Canterbury) suggested at our patients request; an ancient town where they work as a shepherd.</p></div><div><h3>Case Report</h3><p>Our patient presented with a ruptured left common iliac mycotic aneurysm with <em>Campylobacter fetus</em> isolated, requiring emergent endovascular stenting. Seven months post-discharge they re-presented with headache, weight loss and back pain. A half-body fluorodeoxyglucose positron emission tomography (FDG-PET) scan showed aorto-bi-iliac graft uptake in the left periureteric region. The infected graft was explanted and revascularisation obtained with autologous harvested veins.</p></div><div><h3>Results</h3><p>Graft samples grew <em>Nocardia nova</em> 3/5 samples on day 5 of incubation and yellow colonies of a gram-negative on 3/5 samples after 7 days. Identification of <em>Variovorax</em> genus was obtained using the Bruker MALDI-TOF Biotyper (Bruker Daltonics, Germany). <em>Variovorax</em> Sp. DNA was sequenced using Genomic DNA (SQK-LSK109 kit) on GridION (Oxford Nanopore Technologies). Sequence data was filtered and polished with genome Minimap2 and Nanopolish v0.8.4. Epi2Me identified a <em>Variovorax sp</em>.; in silico genomic analysis and in vitro phenotypic testing confirmed it as a new species.</p></div><div><h3>Conclusion</h3><p>As diagnostic capabilities improve unusual clinical isolates can be reliably identified. The Bruker MALDI-TOF allowed identification of <em>Variovorax Sp</em>. causing clinical disease in this setting. This new species was defined with whole-genome sequencing allowing identification and recognition in international repositories.</p><p>This case highlights the importance of an open mind interpreting results from clinical samples as more atypical infections from the environmental microbiome may be isolated.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100332"},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170223001152/pdfft?md5=5e89ed7f5e860ebbe81d63a7f6f6c76d&pid=1-s2.0-S2590170223001152-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138620924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycobacterium abscessus subspecies massiliense infection with anti-interferon-gamma autoantibodies","authors":"Marino Hirata ,&nbsp;Takahiko Fukuchi ,&nbsp;Hitoshi Sugawara ,&nbsp;Ibuki Kurihara ,&nbsp;Keishiro Sueda ,&nbsp;Akira Ishi ,&nbsp;Maya Takazawa ,&nbsp;Yasuhiro Yamaguchi ,&nbsp;Hisashi Oshiro ,&nbsp;Takuro Sakagami","doi":"10.1016/j.clinpr.2023.100333","DOIUrl":"https://doi.org/10.1016/j.clinpr.2023.100333","url":null,"abstract":"<div><h3>Background</h3><p>In recent years, reports of disseminated nontuberculous mycobacterial (NTM) infections in adults with anti-interferon-gamma (IFN-γ) autoantibodies have increased, particularly in Southeast Asia. The absence of previous immunodeficiency and nonspecific initial symptoms in patients are likely to cause a diagnostic delay. Clinical symptoms, imaging findings, and culture of organ specimens are included in the diagnostic criteria; however, the cultures are not always positive. Granuloma formation is a characteristic pathology of NTM infections, assisting in the diagnosis, which is not observed in the presence of immunodeficiency.</p></div><div><h3>Case Report</h3><p>A 69-year-old Japanese woman with no history of immunodeficiency presented with a pulmonary nodule, neutrophilic dermatosis, and pyogenic lymphadenitis. Bronchoscopy, transbronchial aspiration cytology, endobronchial ultrasound-guided transbronchial needle aspiration, computed tomography-guided lung biopsy, thoracoscopic lymph node biopsy, right subclavian lymph node biopsy, skin biopsy, and blood cultures were performed.</p></div><div><h3>Results</h3><p>While the cultures were negative, a pathological examination revealed inflammatory cell infiltrates, mainly composed of macrophages. <em><u>Mycobacterium abscessus</u></em> subsp. <em><u>massiliense</u></em> was recovered in an open biopsy of the left inguinal lymph node. Further, QuantiFERON®TB Gold Plus, a commercialized IFN-γ release assay, was inconclusive, whereas anti-IFN-γ autoantibodies were positive. Notably, eight months after symptom onset, the patient was diagnosed with disseminated <em><u>M. abscessus</u></em> subsp. <em><u>massiliense</u></em> infection associated with adult-onset immunodeficiency due to the presence of anti-IFN-γ autoantibodies.</p></div><div><h3>Conclusion</h3><p>Obtaining this definitive diagnosis was challenging owing to the delayed identification of anti-IFN-γ autoantibodies, a lack of positive cultures, and an absence of granuloma formation. Thus, for early diagnosis, screening for anti-IFN-γ autoantibodies using QuantiFERON®TB Gold Plus, repeated culture examinations, and pathological studies are recommended.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100333"},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170223001164/pdfft?md5=5efd7cfa0bba482cc82d255010182eb2&pid=1-s2.0-S2590170223001164-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138501561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes simplex virus hepatitis in immunocompetent sexually active patient: Case report","authors":"Johny Salem ,&nbsp;Ali Hamdan ,&nbsp;Samia Mitri ,&nbsp;Ayman Tabcheh ,&nbsp;Pierre Hani","doi":"10.1016/j.clinpr.2023.100331","DOIUrl":"https://doi.org/10.1016/j.clinpr.2023.100331","url":null,"abstract":"<div><h3>Introduction</h3><p>Herpes simplex virus (HSV) is a highly prevalent infection, which on rare occasions can become disseminated and be responsible for serious complications including significant neurological, gastrointestinal and even cardiac morbidity. This article presents a case of rare but yet potentially fatal complication of HSV which is hepatitis in an immunocompetent patient.</p><p>Case.</p><p>22 years-old Caucasian female who presented to a peripheral hospital with fever and dysuria. She was admitted to a peripheral hospital and treated for presumptive diagnosis of urinary tract infection without any amelioration in symptoms after multiple days of antibiotics. Deterioration in clinical status triggered transfer to our institution, where further workup yielded the diagnosis of herpes hepatitis which was successfully treated with good patient outcome.</p></div><div><h3>Discussion</h3><p>Hepatitis secondary to HSV is a rare diagnosis that can rapidly progress to fulminant liver failure. Early recognition and treatment within the first 72 h from onset are essential. Yet despite initiation of appropriate antiviral therapy, morbidity and mortality remain high. As a consequence, empiric antiviral therapy should be considered by providers for patients that have such characteristics as the latter ones or have history of HSV in order to avoid the possibly fatal outcomes.</p></div><div><h3>Conclusion</h3><p>HSV hepatitis is difficult to diagnose, it carries a high mortality rate, thus emphasizing on the importance of early diagnosis and treatment to prevent the development of acute liver failure. It should be considered in the differential diagnosis of any case of severe hepatitis.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"21 ","pages":"Article 100331"},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170223001140/pdfft?md5=d6f6c501f6d4143077b682f9938effdc&pid=1-s2.0-S2590170223001140-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138501562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}