A fatal hepatitis A virus with dengue fever co-infection

Area of Science:

• Pediatric Infectious Diseases
• Hepatology
• Virology

Background:

• Hepatitis A virus (HAV) and dengue virus (DENV) are significant global pathogens.
• Co-infections with different viral agents can alter disease presentation and severity.
• Acute fulminant hepatic failure is a rare but life-threatening complication of viral hepatitis.

Observation:

• A 4-year-old boy presented with symptoms of Hepatitis A virus infection.
• Following partial recovery from HAV, the child developed Dengue virus infection.
• The co-infection rapidly progressed, leading to acute fulminant hepatic failure.

Findings:

• This case represents the first reported pediatric fatality due to co-infection with Hepatitis A virus and Dengue virus.
• Acute fulminant hepatic failure was a critical complication in this co-infected child.
• The clinical course demonstrated a severe outcome following sequential viral infections.

Implications:

• Clinicians should consider the possibility of DENV co-infection in children with pre-existing Hepatitis A infection presenting with acute liver failure.
• Early recognition and management of DENV co-infection are crucial in pediatric patients with HAV.
• This case underscores the importance of understanding viral co-pathogenesis and its impact on severe liver disease in children.