Case report: severe respiratory alkalosis--unusual manifestation of viral hepatitis

A middle-aged man who had been in good general health presented with marked hyperventilation and severe respiratory alkalosis. Typical signs and symptoms of viral hepatitis subsequently developed. Investigation showed that he and 32 other patients with hepatitis had all eaten at the same restaurant prior to illness. Because of his distressing constitutional symptoms and markedly elevated hepatic enzyme levels, corticosteroid therapy was begun. The symptoms and hyperventilation improved dramatically. Although respiratory alkalosis has been observed during the course of other infectious diseases, to our knowledge it has not previously been reported in association with hepatitis A infection.