A 22-year-old female presented with unexplained, non-specific, constitutional symptoms of fever, chills, rigors, and headaches of more than two-week duration. An extensive workup was done that included labs, imaging, and a liver biopsy. On examination, lymphadenopathy was found, with worsening transaminitis on labs. She was ultimately found to be hepatitis E positive. The disease was self-limited with subsidence of all symptoms with only symptomatic treatment. Hepatitis E virus infection can be a missed diagnosis as it is not common in the United States. An indicated differential diagnosis can save an extensive workup and prevent delayed diagnosis for a patient.
Keywords: antivirals; enteric transmission; hepatitis e; liver failure; unexplained fever.
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