title: Hepatitis Aand E Co-Infection with Worst Outcome.
abstract: Infections are still a major problem in the developing countries like Pakistan because of poor sewage disposal and economic restraints. Acute viral hepatitis like Aand E are not uncommon in pediatric age group because of unhygienic food handling and poor sewage disposal, but majority recovers well without any complications. Co-infections are rare occurrences and physicians need to be well aware while managing such conditions to avoid worst outcome. Co-infection with hepatitis Aand E is reported occasionally in the literature, however, other concurrent infections such as hepatitis A with Salmonellaand hepatotropic viruses like viral hepatitis B and C are present in the literature. Co-infections should be kept in consideration when someone presents with atypical symptoms or unusual disease course like this presented case. We report here a girl child who had acute hepatitis A and E concurrent infections and presented with hepatic encephalopathy and had worst outcome, despite all the supportive measures being taken.
authors.affiliation: 1. Department of Pediatric, Collge of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia. 2. Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Anjum
authors.initials: A
authors.lastname: Saeed
authors.affiliation: Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Huma Arshad
authors.initials: HA
authors.lastname: Cheema
authors.affiliation: 1. Department of Pediatric, Collge of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia. 2. Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Asaad
authors.initials: A
authors.lastname: Assiri
mesh_terms: D002648:Child; D060085:Coinfection; D017809:Fatal Outcome; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications / Q000209:etiology*; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis*; D030041:Hepatitis A virus / Q000302:isolation & purification; D016751:Hepatitis E / Q000150:complications / Q000175:diagnosis*; D016752:Hepatitis E virus / Q000302:isolation & purification; D006801:Humans; D007565:Jaundice / Q000209:etiology*; D008111:Liver Function Tests; D012367:RNA, Viral / Q000097:blood
chemical_list: D012367:RNA, Viral