A Superinfection of Salmonella typhi and Hepatitis E Virus Causes Biphasic Acute Hepatitis

被引:1
作者
Suda, Takeshi [1 ]
Iguchi, Ryo [2 ]
Ishiyama, Takaaki [3 ]
Kanefuji, Tsutomu [4 ]
Hoshi, Takahiro [1 ]
Abe, Satoshi [1 ]
Morita, Shinichi [1 ]
Yagi, Kazuyoshi [1 ]
机构
[1] Niigata Univ Med & Dent Hosp, Uonuma Inst Community Med, Dept Gastroenterol & Hepatol, Niigata, Japan
[2] Natl Hosp Org Shizuoka Med Ctr, Div Gen Internal Med, Shizuoka, Japan
[3] St Louis Univ, Hosp Med Sect, Dept Internal Med, St Louis, MO 63103 USA
[4] Tsubame Rosai Hosp, Dept Gastroenterol & Hepatol, Niigata, Japan
关键词
typhoid hepatitis; hepatitis E; coinfection; ALT/LDH ratio; acute cholecystitis; FEVER; SEROPREVALENCE; BURDEN; MODEL; HEV;
D O I
10.2169/internalmedicine.6458-20
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A 47-year-old Japanese man was referred to our hospital because of a sustained high fever with diarrhea 12 days after a flight from India. Liver enzymes were elevated with rose spots, hepatosplenomegaly, relative bradycardia, and acute cholecystitis. A liver biopsy depicted the dense infiltration of lymphocytes and Kupffer cells in sinusoids and the granulomatous formation in the parenchyma. The liver damage was initially resolved with the administration of ceftriaxone for 16 days but flared up 1 week later. Laboratory tests yielded positive reactions for Salmonella typhi and hepatitis E virus RNA. The pathophysiological presentations of concurrent typhoid and type E hepatitis are discussed.
引用
收藏
页码:1717 / 1722
页数:6
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