Severe yellow fever with 23-day survival

In a severe case of jungle yellow fever, acquired in the Brazilian mid-west region, clinical and laboratory evidence of hepatic and renal failure, cardiovascular disturbance, coma and bleeding disorder developed. The patient was treated in an intensive care unit and hemodialysis was performed. In spite of severe liver dysfunction, most biochemical parameters returned to normal values but the patient finally died of respiratory failure on the 23rd day, due to secondary bacterial pneumonia. A post-mortem liver biopsy showed regeneration of normal liver architecture. Without the bacterial respiratory complication, the patient probably would have survived.