A RARE CASE OF FULMINANT HEPATITIS DUE TO LEPTOSPIROSIS IN A BOY IN HIS TEENS IN TRIPURA : CASE REPORT

Abstract

Fulminant hepatitis (FH) is a rare and devastating syndrome caused by a variety of hepatic insults. It is characterized by severe metabolic derangements, neurologic complications and ultimately, multiorgan failure. The pathogenesis includes both direct and immune-mediated liverinjury triggered by diverse aetiologies. Leptospirosis is an infection caused by Leptospira. Leptospirosis causes disease in humans mainly indeveloping countries. Clinical presentation of Leptospirosis is unclear and can vary from u-like febrile illness to rapidly fatal infection. Typically present with fever, headache, myalgia. Severe forms, like meningitis, pulmonary hemorrhage, Weil's syndrome with jaundice, and acute kidney injury are also there. It has been reported in few instances that Leptospirosis can cause Fulminant Hepatitis. A Male patient in his early Teens, Hindu
by religion from Rural area of Tripura admitted with yellowish discoloration of both eyes, Pain Abdomen, Altered sensorium with history of Fever. Final Diagnosis was made as Fulminant Hepatitis due to Leptospirosis. Finding a case of leptospirosis in a non endemic state of Tripura is very signicant. The patient has High Total Leucocyte count, Hypokalemia & Proteinuria, High ALP level & Tyrosine needles in urine which supports the diagnosis.