Herpes Simplex Virus

 Characterized by ground-glass or smudged nuclei with margination of chromatin

• Multinucleated cells with nuclear molding are less common compared with mucocutaneous HSV infections
• Immunohistochemistry with antibodies directed against HSV1/HSV2 confirm diagnosis

Top Differential Diagnoses

• Acetaminophen toxicity
• Toxin-induced liver injury
• Adenovirus hepatitis
• Wilson disease
• Acute vascular injury
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Minimal InflammationH&E shows extensive hemorrhagic necrosis with negligible portal and lobular inflammation.

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Nuclear InclusionsH&E shows herpes simplex virus (HSV) inclusions at the interface of necrotic and viable areas. In most cells, the inclusions appear as eosinophilic ground-glass areas in the nucleus with margination of nuclear chromatin image .
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Nuclear InclusionsH&E shows viral inclusions image with smudged hepatocyte nuclei and margination of nuclear chromatin. The inclusions are typically located at the edge of necrotic zones. A prominent owl-eye like appearance typical of CMV inclusions is not present in most HSV inclusions.
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Multinucleated CellH&E shows a multinucleated cell image with nuclear molding. These cells are commonly observed in herpetic mucosal lesions but are uncommon in HSV hepatitis.

TERMINOLOGY

Abbreviations

• Herpes simplex virus (HSV) hepatitis

ETIOLOGY/PATHOGENESIS

Infectious Agents

• Hepatitis is result of disseminated infection and can occur with both HSV1 and HSV2
• Dissemination may occur due to immunosuppression, large initial inoculum, enhanced virulence at reactivation, or hepatovirulence of certain strains

CLINICAL ISSUES

Epidemiology

• Incidence
image Risk factors
– Immunosuppression
– Neonates
– 3rd trimester of pregnancy

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Related posts:

  1. Congenital Hepatic Fibrosis
  2. Hepatoportal Sclerosis
  3. Drug-Related Acute Hepatitis
  4. Biliary Atresia

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Apr 20, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Herpes Simplex Virus

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