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Unusual oral presentation of HSV-1 lesions in an adult liver transplant recipient
  1. Daniel Yiu1,
  2. Michele Ballabio2,
  3. Gianluca Fornoni2 and
  4. Umberto Maggi3
  1. 1 General Surgery, Frimley Health NHS Foundation Trust, Slough, UK
  2. 2 UO Chirurgia Generale e Trapianti di Fegato, Ospedale Maggiore Policlinico, Milano, Italy
  3. 3 HPB and Liver Transplant Unit, Osped Maggiore Policlin Milano, Milano, Italy
  1. Correspondence to Dr Daniel Yiu, DANIEL.YIU{at}NHS.NET


Herpes Simplex Virus (HSV) hepatitis in liver transplant patients is a rarely reported infective complication of HSV with severe consequences, often leading to fulminant hepatitis if left untreated. The clinical signs are often atypical, leading to under-reporting in the literature and potential delays in treatment. Our case report describes such atypical mucocutaneous lesions in a liver transplant recipient. We highlight the need for further reports, especially those with images, in order to aid the diagnosis of HSV infection, and to allow prompt treatment to prevent complications such as HSV hepatitis.

  • dermatology
  • infectious diseases
  • transplantation
  • herpes simplex virus
  • liver disease

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  • Contributors DY was in charge of the case report design and planning. He co-wrote the background and discussion, performing the background research. He was also involved in the interpretation of the lesions from a dermatological perspective and oversaw editing of the paper. MB and GF were involved in conducting the investigations and management of the patient. They were involved in retrieving, analysing and interpreting the clinical data. They co-wrote the clinical narrative as well as drafting the paper. UM was involved with the conception and design of the case report structure. UM was the most senior member overseeing the patient’s care and involved in the interpretation of data, as well as critical revision of the report. He provided the background knowledge and research from a liver transplant specialist perspective. All authors are in agreement over the final draft of the case report and agree to be accountable.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.