Fulminant herpes simplex viral hepatitis: ultrasound and CT imaging appearance and a review of the imaging literature

We report the case of a previously healthy 21-year-old woman who presented 6 days post-partum in acute fulminant hepatic failure. A liver ultrasound demonstrated normal echogenicity without discrete nodules while an enhanced computed tomography (CT) demonstrated innumerable 1- to 3-mm hypodense nodules throughout the liver with greater involvement of the left lobe. Liver biopsy confirmed herpes simplex virus infection. We believe this disease has a characteristic appearance on CT and prompt recognition can expedite diagnosis and therapy.