Case report
Autochthonous hepatitis E in a patient from Zagreb: a case report
Rok Čivljak
orcid.org/0000-0001-8766-7438
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Oktavija Đaković Rode
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Lorena Jemeršić
; Hrvatski veterinarski institut, Zagreb, Hrvatska
Antea Topić
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Ivan Turalija
; Dom zdravlja Zagreb-Zapad, Zagreb, Hrvatska
Ilija Kuzman
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Marko Čačić
; KBC Zagreb, Zagreb, Hrvatska
Abstract
Hepatitis E virus (HEV) is a global pathogen that causes epidemic and sporadic cases of acute hepatitis in Asia and Africa. However, recently, sporadic cases have been recorded in European countries as well. In November 2012, a 62-year-old patient was admitted with suspicion of bacterial pneumonia. The disease started two weeks prior to admission with fever and respiratory symptoms. The regression of symptoms was noted during outpatient treatment with cefuroxime-axetil. On the sixth day of treatment a rash appeared and the patient was admitted to our hospital. On admission, he was icteric, with an erythematous macular rash on the trunk. Laboratory tests found moderately elevated inflammatory parameters with hyperbilirubinemia and elevated liver enzymes. On chest X-ray extensive interstitial pulmonary infiltration was recorded. Serological and molecular diagnostics confirmed acute HEV-infection. Serological diagnostics on microorganisms of atypical pneumonia suggested possible simultaneous C. pneumoniae infection. Symptomatic treatment achieved a complete cure with normalization of laboratory tests after three months follow-up, without any complications. In this paper, we presented a case of an icteric form of acute hepatitis E in a patient from Zagreb who didn' travel abroad, therefore according to avaliable literature, this is the first described case of autochthotonous hepatitis E in Croatia. During the course of the disease the patient developed a rash and pneumonic infiltration the etiology of which could not be clearly defined. In patients with clinical feature of acute viral hepatitis after exclusion of hepatitis A, B, C and EBV and CMV infections, diagnostic on HEV should be conducted.
Keywords
Hepatitis E virus; viral hepatitis; hepatitis E; autochthonous hepatitis; respiratory manifestations; Croatia
Hrčak ID:
106540
URI
Publication date:
31.3.2013.
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