Subject: Clinical medicine
Year: 2023
Type: Conference or Workshop Item
Type: PeerReviewed
Title: Unusual case of acute viral hepatitis in a 5 year old girl
Author: Dimitrovska Ivanova, Marija
Abstract: Backround and aims: In most of the cases acute viral hepatitis in children is caused by hepatitis virus type A. There are rare cases where other types of hepatitis virus or other viruses such as Ebstain Barr Virus (EBV) and Cytomegalovirus (CMV) can cause acute hepatitis. This is an unusual case of acute viral hepatitis in a 5 year old girl caused by concomitant EBV and CMV infection. Methods: Five year old girl presented with fever, fatigue, headache, nausea, vomiting, abdominal pain, swelling of upper eyelids and darker urine. On physical examination conscious, pale, febrile (39 C) dehydrated, icteric sclera, pharynx hyperemic, oedema of upper eyelids, pain and hepatosplenomegaly on abdominal palpation. Sucussio renalis negative.Blood tests with leukocytosis (Le=28,35 with Ly=72,4%), Hgb= 108g/l, CRP= 34mg/l, AST= 470U/L, ALT= 684U/L, GGT= 95U/L, Total billirubin= 87.7umol/l, Direct Billirubin= 69,8 umol/l. Serological test for hepatitis A, B, C were negative. EBV IgM and CMV IgM were positive. Urine test positive for aceton and billirubin. Abdominal ultrasound with small hepatosplenomegaly and 70 ml of free liquid in Douglas space Results: After apropriate conservative treatment, with gradually decrease of hepatic enzymes and bilirubin values, normalization of urine color, withdrawal of abdominal organomegaly, disapearing of free liquid in Douglas space and improvement of general condition. Conclusion: Concomitant infection od EBV and CMV are rare causes of acute hepatitis. In most of the cases it is manifested as noncomplicated infective mononucleosis, but symptomatic hepatitis is rare. We should consider infectious mononucleosis hepatitis in differentiating patients presenting with liver abnormality, fever, pharyngitis, and lymphadenopathy.
Publisher: Frontiers Media S.A.
Relation: https://eprints.ugd.edu.mk/32023/
Identifier: oai:eprints.ugd.edu.mk:32023
Identifier: https://eprints.ugd.edu.mk/32023/1/EAPS%202022%20OCTOBER%20BARCELONA.pdf1.pdfIdentifier: https://eprints.ugd.edu.mk/32023/2/Cronhn%27s%20colitis%20in%20a%2010%20year%20old%20boy.pdfIdentifier: Dimitrovska Ivanova, Marija (2023) Unusual case of acute viral hepatitis in a 5 year old girl. In: The 9th Congress of the European Academy of Paediatric Societies, 7-11 Oct 2022, Barcelona.
