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| Subacute fulminant hepatic failure with intermittent fever |
| Cong-Xin Chen, Bo Liu, Yong Hu, Joyce E. Johnson and Yi-Wei Tang |
Hefei, China
Author Affiliations: Department of Infectious Diseases (Chen CX and Liu B), and Department of Pathology (Hu Y), 105th Hospital, Hefei 230031, China; Molecular Infectious Diseases Laboratory and Molecular Epidemiology, Medical Center, Vanderbilt University, Nashville, TN 37232-5310, USA (Johnson JE and Tang YW)
Corresponding Author: Cong-Xin Chen, MD, Department of Infectious Diseases, 105th Hospital, Hefei 230031, China (Email: congxinc@mail.hf.ah.cn) |
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Abstract BACKGROUND: Viral hepatitis B accounts for over 80% of acute hepatic failures in China and the patients die mainly of its complications. A patient with hepatic failure and fever is not uncommon, whereas repeated fever is rare.
METHODS: A 32-year-old female was diagnosed with subacute hepatic failure and hepatitis B viral infection because of hyperbilirubinemia, coagulopathy, hepatic encephalopathy, serum anti-HBs-positive without hepatitis B vaccination, and typical intrahepatic pathological features of chronic hepatitis B. Plasma exchange was administered twice and she awoke with hyperbilirubinemia and discontinuous fever.
RESULTS: Urethritis was confirmed and medication-induced fever and/or spontaneous bacterial peritonitis (Gram-negative bacillus infection) was suspected. The patient was treated with antibiotics, steroids and a Chinese herbal medicine, matrine, for three months and she recovered.
CONCLUSION: The survival rate of patients with hepatic failure might be improved with comprehensive supporting measures and appropriate, timely management of com-plications.
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2009, Vol. 8 
