Fulminant hepatic and multiple organ failure following acute viral tonsillitis: a case report.

Bechtel-Grosch, Ursina; Béguelin, Charles Antoine; Berezowska, Sabina Anna; Dufour, Jean-François; Takala, Jukka; Schefold, Joerg C. (2016). Fulminant hepatic and multiple organ failure following acute viral tonsillitis: a case report. Journal of medical case reports, 10(7), p. 7. BioMed Central 10.1186/s13256-015-0777-3

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BACKGROUND Pyogenic tonsillitis may often be observed in the general Western population. In severe cases, it may require antibiotic treatment or even hospitalization and often a prompt clinical response will be noted. Here we present an unusual case of progressive multiple organ failure including fulminant liver failure following acute tonsillitis initially mistaken for "classic" pyogenic (that is bacterial) tonsillitis. CASE PRESENTATION A 68-year-old previously healthy white man was referred with suspicion of pyogenic angina. After tonsillectomy, he developed acute liver failure and consecutive multiple organ failure including acute hemodynamic, pulmonary and dialysis-dependent renal failure. Immunohistopathological analysis of his tonsils and liver as well as serum polymerase chain reaction analyses revealed herpes simplex virus-2 to be the causative pathogen. Treatment included high-dose acyclovir and multiorgan supportive intensive care therapy. His final outcome was favorable. CONCLUSIONS Fulminant herpes simplex virus-2-induced multiple organ failure is rarely observed in the Western hemisphere and should be considered a potential diagnosis in patients with tonsillitis and multiple organ failure including acute liver failure. From a clinical perspective, it seems important to note that fulminant herpes simplex virus-2 infection may masquerade as "routine" bacterial severe sepsis/septic shock. This persevering condition should be diagnosed early and treated goal-oriented in order to gain control of this life-threatening condition.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Bechtel-Grosch, Ursina; Béguelin, Charles Antoine; Berezowska, Sabina Anna; Dufour, Jean-François; Takala, Jukka and Schefold, Joerg C.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1752-1947

Publisher:

BioMed Central

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

29 Jun 2016 09:58

Last Modified:

18 Jan 2017 09:08

Publisher DOI:

10.1186/s13256-015-0777-3

PubMed ID:

26785992

BORIS DOI:

10.7892/boris.83467

URI:

https://boris.unibe.ch/id/eprint/83467

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