A Rare Presentation of Hepatitis A Infection with Extrahepatic Manifestations

Abstract EN

Hepatitis A has a variety of associated extrahepatic manifestations that clinicians should be aware of for early diagnosis and treatment.

We report a unique case of hepatitis A presenting with multiple extrahepatic manifestations not previously described in a single patient.

A 34-year-old male presented with sudden onset of left sided facial pain, swelling, and skin rash, with diffuse body pains and muscle weakness, and was found to be positive for hepatitis A immunoglobulin M (IgM).

He was initially started on antibiotics for concerns of bacterial parotitis but did not show any improvement.

A punch biopsy of his mandibular rash and swelling was done which showed lymphohistiocytic infiltration with a few eosinophils.

A trial of prednisone resulted in improvement of his symptoms.

Clinicians should be aware to look for hepatitis A infection in a patient with atypical clinical picture causing a widespread systemic inflammatory response.

Treatment with prednisone may result in resolution.