title: Acute hepatitis a virus infection presenting with multiorgan dysfunction: a case report.
abstract: BACKGROUND
  Acute hepatitis due to hepatitis a virus is usually a benign self-limiting disease conferring lifelong immunity. However, few cases have been reported in literature with fulminant hepatitis. We report this extremely rare case with multiorgan dysfunction including liver failure, hepatic encephalopathy, renal failure, pleural effusion, pericardial effusion and hematologic dysfunction as a sequale of this infection in an otherwise healthy male at the age of 18.
  
  
  METHODS
  An 18 years old Pakistani male presented with two days history of fever, cough, headache and vomiting. His condition gradually deteriorated and on day 7 developed multiorgan dysfunction. Initially Immunoglobulin M anti hepatitis a virus was borderline 1.40 but repeated titers one week later confirmed the diagnosis of acute hepatitis a virus infection.
  
  
  CONCLUSIONS
  This original case report highlights the importance of focusing first uncommon manifestations of common illnesses while diagnosing difficult cases. Moreover this case also adds knowledge to the limited available data regarding complications and predictors of prognosis.
authors.affiliation: Combined Military Hospital Rawalpindi Pakistan. drrasheeed@yahoo.com
authors.forename: Abdul
authors.initials: A
authors.lastname: Rasheed
authors.forename: Shahzad
authors.initials: S
authors.lastname: Saeed