Key result
Steroids for DRESS syndrome linked to rare disseminated HSV-2 presenting with ischemic colitis and toxic megacolon.
Why the study?
HSV infection is usually mild but can cause severe morbidity and mortality in immunocompromised patients, with rare presentations such as necrotizing ischemic colitis and toxic megacolon.
Case Report (n=1)
Highlights a rare case of severe HSV-2 infection presenting with necrotizing ischemic colitis and toxic megacolon in an immunosuppressed patient.
Suggests vigilance for HSV-2 colitis in steroid-treated patients; single case leaves open incidence and screening needs.
More than 90% of people worldwide are seropositive for herpes simplex virus (HSV) by the fourth decade of their lives. HSV is usually asymptomatic or follows a mild, self-limited course in healthy individuals. In severely immunocompromised hosts or in patients with underlying inflammatory bowel disease (IBD) treated with immunomodulators, HSV can cause significant morbidity and mortality, including mucocutaneous ulcerations, esophagitis, hepatitis, and encephalitis. This is a rare case of HSV-2 causing necrotizing ischemic colitis, toxic megacolon, and necroinflammation of the liver in the absence of transaminitis in a patient who received steroids for drug rash with eosinophilia and systemic symptoms (DRESS) syndrome.
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Alitter et al. (2023) conducted a case report in Disseminated HSV-2 infection (n=1). Steroid therapy was evaluated. A 70-year-old female treated with steroids for DRESS syndrome developed a rare case of disseminated HSV-2 infection presenting with toxic megacolon, ischemic colitis, and hepatitis.
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