A Case of Reactivated Acute Hepatitis in a 12-month-old Infant With Multiviral Infection, Including SARS-CoV-2 and Adenovirus

Author:

Dawood Jimmy1,Wickersham Emily L.234,Witmer Claire P.56,Jones Milissa U.56

Affiliation:

1. School of Medicine, Uniformed Services University, MD

2. Department of Pathology, Tripler Army Medical Center, Honolulu, HI

3. Department of Pathology, Uniformed Services University, MD

4. Branch Health Clinic Makalapa and Kaneohe Laboratories

5. Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI

6. Department of Pediatrics, Uniformed Services University, MD

Abstract

Adenovirus hepatitis is of global concern due to its increasing incidence and poorly understood pathogenesis. Historically, adenovirus has contributed to the development of severe hepatitis in immunocompromised patients. The clinical course and management of such infections in previously healthy children remains elusive. We present a case of severe acute hepatitis in a previously healthy 12-month-old infant with a history of SARS-CoV-2 infection followed by multiviral infection including adenovirus. Additional evaluation revealed acute hepatitis without evidence of acute liver failure except for mild coagulopathy. She demonstrated clinical improvement with supportive therapy but later experienced reactivated hepatitis in the setting of a third new viral infection thereby warranting a second hospitalization. A liver biopsy was obtained due to concern for an underlying immunologic or metabolic etiology of her prolonged hepatitis. Our case provides insight into the medical management and clinical course of a previously healthy child with a history of SARS-CoV-2 and adenovirus infections leading to reactivated acute hepatitis.

Publisher

Wiley

Subject

General Earth and Planetary Sciences,General Environmental Science

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