, Volume 57, Issue 11, pp 2811-2813
Date: 07 Mar 2012

Acute Fulminant Hepatic Failure Associated with Parvovirus B19 Infection in an Immunocompetent Adult

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Case Presentation and Evolution

A previously healthy 21-year-old female presented with epigastric pain, nausea, vomiting, arthralgias, and decreased appetite. Three weeks before presentation, she had developed cough, fevers, chills, and coryza immediately following a similar illness in her 4-year-old daughter. Although in the interval her respiratory symptoms had resolved, she continued to experience fevers, chills, and arthralgias. Three days before presentation she began to notice mid-epigastric pain, severe headache, profound nausea, and non-bilious, non-bloody vomiting. She denied other sick exposures, alcohol use, illicit drug use, or recent travel history.

At an outside hospital, an aspartate aminotransferase level (AST) of 954 U/L (normal value, 10–32 U/L), alanine aminotransferase level (ALT) of 1,300 U/L (0–30 U/L), total bilirubin level of 3.9 mg/dL (normal value, 0.2–1.2 mg/dL), and alkaline phosphatase level of 98 U/L (normal value, 30–120 U/L) were reported. She was discharg ...