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Volume 45, Number 4, August 2012

 Herpetic gingivostomatitis with severe hepatitis in a previously healthy child


Chun-Kuei Chen, Shih-Hao Wu, Yhu-Chering Huang


Received: May 25, 2011    Revised: July 6, 2011    Accepted: August 10, 2011   

 

Corresponding author:

Yhu-Chering Huang,  Department of Pediatrics, Chang Gung Memorial Hospital, No. 5, Fu-Shin Street, Kweishan, Taoyuan

County 333, Taiwan. E-mail address: ychuang@adm.cgmh.org.tw (Y.-C. Huang).


 

Background and purpose: 

 A previously healthy boy aged 9 years and 11 months was admitted due to herpetic gingivostomatitis

with poor intake. He also had fever, neutropenia, and elevated serum aminotransferase level (> 1000 U/mL). Prolonged prothrombin time, mild gastrointestinal hemorrhage and transient decreased conscious level were noted during hospital days 2 and 3. Intravenous acyclovir therapy commenced on  hospital day 2 and his serum aminotransferase level peaked(> 4000 IU/mL) on hospital day 3 and then improved gradually. A throat swab was positive for human herpes simplex virus (HSV)-1, serological test was positive for acute primary HSV-1 infection, and a blood specimen was also strongly positive for HSV-1 by polymerase chain reaction. He received a 14-day course of intravenous acyclovir and recovered uneventfully. Herpetic gingivostomatitis, although mostly benign and self-limited, may be complicated with severe hepatitis, even in immunocompetent hosts.


 

Key words:

 Acyclovir; Gingivostomatitis; Hepatitis; Herpes simplex virus-1