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Case Reports
A Superinfection of Salmonella typhi and Hepatitis E Virus Causes Biphasic Acute Hepatitis.
- Takeshi Suda, Ryo Iguchi, Takaaki Ishiyama, Tsutomu Kanefuji, Takahiro Hoshi, Satoshi Abe, Shinichi Morita, and Kazuyoshi Yagi.
- Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical & Dental Hospital, Japan.
- Intern. Med. 2021 Jun 1; 60 (11): 1717-1722.
AbstractA 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.
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