Optimal management of herpes simplex virus in patients with inflammatory bowel disease includes targeted prophylactic therapy for patients with evidence of latent infection, and timely initiation of antiviral therapy for those patients suspected to have invasive disease.Herpes simplex virus 1 (HSV-1) can be responsible for life-threatening HSV encephalitis (HSE).
Disseminated herpes simplex virus infection with concomitant involvement of the colon and liver has been reported only 3 times in the published literature, and to our knowledge this is the first such case in a patient with inflammatory bowel disease.
The study included adults from northern France whose cerebrospinal fluid (CSF) was positive for HSV by PCR.
In contrast to post-transplant B-cell lymphomas (systemic and primary cutaneous), the link to a virus has not been demonstrated. Early treatment with intravenous acyclovir led to a rapid improvement of the patients' condition and resulted in a full recovery of her liver function.
Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastroenterological disorders seen most often in The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Addressforreprint requests: DrDJSCarmichael, St Mary'sHospi-tal, London W21PG. Three months later, regarding suboptimal response to medical therapy, the patient underwent total proctocolectomy and ileoanal pouch anastomosis. Comprehensive diagnostics including blood HSV-1 PCR, liver biopsy, and immunohistochemistry revealed the diagnosis of fulminant herpes hepatitis. The medical charts of 2573 patients were reviewed retrospectively. A total of 122 520 subjects (24 504 patients with SLE and 98 016 age-matched and sex-matched non-SLE controls) were included, and a higher IR of severe HSV infection was revealed in the SLE group (IR ratio=3.93, p<0.001). In 565 patients seen in the authors' unit within the first three months after diagnosis, characteristics of Crohn's disease at diagnosis did not differ from one cohort to another.
The cumulative risk of developing a stricturing or a penetrating intestinal complication remained also unchanged. However, few attempts to analyse the associated incidence and risk factors have been made. Corticosteroids could have an important role in the management of Herpes simplex encephalitis because their anti-inflammatory action reduces cerebral oedema. Published with practicing clinicians in mind, the journal aims to be easily accessible, organizing its content by topic, both online and in print. Published with practicing clinicians in mind, the journal aims to be easily accessible, organizing its content by topic, both online and in print.
In addition corticosteroids may decrease the extent of infection in their own right.
Moreover, the clinical efficacy of the proposed treatment was established for patients with the recurrent HSV 1/2-infection: in the group of patients with the mild course of HSV 1/2-infection it was 73,5% after the treatment and 85,8% in the remote period; in the group of patients with the mild and severe course of HSV 1/2-infection it was 64,0% after the treatment and 70,4% in the remote period.We present the case of a Herpes simplex virus-1 (HSV-1) sepsis with severe herpes hepatitis in a young female treated with triple immunosuppressive therapy (adalimumab, azathioprine, prednisolone) for refractory Crohn's disease (CD). patients (65%). In this study, factors associated with late initiation of acyclovir were identified. Immunosuppressive treatments used in the management of Inflammatory Bowel Disease, namely steroids, thiopurines and anti-TNF drugs, raise the risk of acquiring opportunistic infections.
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