Dengue fever with fulminant hepatic failure - A case report

Dengue Fever is a rare cause of fulminant hepatic failure. So far, only a few case reports of fulminant hepatic failure occurring in adults with dengue fever, who were successfully treated, are available. We report a case of fulminant hepatic failure due to dengue fever. A 26 year old previously healthy female was admitted with fever, jaundice and anasarca. She was tested positive for dengue NS1Ag. Her biochemical and clinical parameters were suggestive of acute liver failure with total billirubin of 7.6 mgdL, direct billirubin of 4.2 mgdL, indirect bilirubin 3.4 mg per dl, ALT 101 IU, AST 165 IU, ALP 88 IU, PT INR 2.0, hemoglobin 5.6 gms per dl, hematocrit 16 and platelet count of 1.2 lakhs per mm3. Other causes for acute hepatic failure like viral hepatitis, leptospirosis and malaria were ruled out. The patient was treated for hepatic encephalopathy and managed with supportive care and 1 unit of whole blood transfusion. With treatment she made a steady recovery. She was discharged in stable condition after 13 days of in-hospital stay.