Severe acute hepatitis E infection presenting with acute abdomen and meningoencephalitis

BMJ Case Rep. 2020 Dec 13;13(12):e236922. doi: 10.1136/bcr-2020-236922.

Abstract

We present a case of a 50-year-old man admitted due to acute abdomen, icterus and fever. The patient had a history of sufficiently treated type 2 diabetes and a high daily alcohol consumption, no recent travel history and had a strictly heterosexual and monogamous way of living. A full blood count displayed severe elevated liver enzymes. A CT of the abdomen was performed and revealed steatosis but no acute abdominal pathology. During admission, the patient developed signs of meningoencephalitis. A lumbar puncture was performed, and the cerebrospinal fluid revealed lymphocytic pleocytosis consistent with mild inflammation. Furthermore, hepatitis E was found in the blood and the definitive diagnosis was established. The patient gradually recovered and was discharged within 8 days of admission. To the best of our knowledge, we present the second case describing concomitant hepatitis and meningoencephalitis, resolving spontaneously and not giving rise to sequelae.

Keywords: hepatitis and other GI infections; infectious diseases; meningitis.

Publication types

  • Case Reports

MeSH terms

  • Abdomen, Acute / virology*
  • Acute Disease
  • Alcoholism / complications
  • Diabetes Mellitus, Type 2 / complications
  • Diagnosis, Differential
  • Hepatitis E / diagnosis*
  • Humans
  • Male
  • Meningoencephalitis / virology*
  • Middle Aged
  • Risk Factors