Diagnosis and Management of a Triple Infection with Leptospira spp., Hepatitis A Virus, and Epstein–Barr Virus: A Rare Occurrence with High Hepatotoxic Effect
Abstract
:1. Introduction
2. Case Presentation
3. Discussion
3.1. Case Features
3.2. Similar Findings
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Laboratory Tests | Normal Range | In the Emergency Room of the County Hospital | 1 Day After Admission | 5 Days After Admission | 8 Days After Admission | 12 Days After Admission | 15 Days After Admission | 20 Days After Admission |
---|---|---|---|---|---|---|---|---|
Leucocytes | 4000–10,000/µL | 7200/µL | 7940/µL | 7450/µL | 6900/µL | 6350/µL | 6400/µL | 6580/uL |
Lymphocytes | 25–40% | 29.7% | 28.8% | 29.0% | 29.2% | 29.9% | 31.1% | 27.8% |
Monocytes | 5.5–10% | 6.7% | 14.4% | 16.5% | 17.1% | 17.9% | 19.0% | 16.3% |
Neutrophils | 55–65% | 63.6% | 53.6% | 51.8% | 50.8% | 50.0% | 47.2% | 54.8% |
Prothrombin time | 9.4–12.1 s | 11.8 s | 12.4 s | 13.0 s | 13.2 s | 13.0 s | 12.1 s | 11.5 s |
ALT | 0–40 U/L | 3911 U/L | 1611 U/L | 1128 U/L | 661 U/L | 181 U/L | 298 U/L | 503.8 U/L |
AST | 0–41 U/L | 2384 U/L | 503 U/L | 405 U/L | 263 U/L | 72.6 U/L | 115 U/L | 246.4 U/L |
Total Bilirubin | 0–1.2 mg/dL | 4.9 mg/dL | 7.0 mg/dL | 7.56 mg/dL | 8.13 mg/dL | 10.38 mg/dL | 6.29 mg/dL | 3.76 mg/dL |
Direct Bilirubin | 0–0.2 mg/dL | 4.4 mg/dL | 6.38 mg/dL | 6.98 mg/dL | 7.66 mg/dL | 8.94 mg/dL | 5.85 mg/dL | 3.26 mg/dL |
Cholinesterase | 5320–12,920 U/L | 6502 U/L | 6351 U/L | 6086 U/L | 6641 U/L | 6934 U/L | 6885 U/L | 6872 U/L |
Creatinine | 0.6–1.2 mg/dL | 0.8 mg/dL | 0.89 mg/dL | 0.99 mg/dL | 0.96 mg/dL | 1.12 mg/dL | 1.15 mg/dL | 1.09 mg/dL |
Vitamin D | 20–40 ng/mL | 17 ng/mL | 17 ng/mL | 19 ng/mL | 20 ng/mL | 21 ng/mL | 23 ng/mL | 24 ng/mL |
CRP | <10 mg/L | 94 mg/L | 92 mg/L | 58 mg/L | 33 mg/L | 7 mg/L | 3 mg/L | 1 mg/L |
Procalcitonin | <0.5 ng/mL | 1.2 ng/mL | 1.5 ng/mL | 0.73 ng/mL | 0.31 ng/mL | 0.28 ng/mL | 0.22 ng/mL | 0.2 ng/mL |
Proteinuria | <150 mg/day | Negative | Negative | Negative | Negative | Negative | Negative | Negative |
Hematuria | 0–2 RBC | 3–5 RBC | 3–5 RBC | 3–5 RBC | 0–2 RBC | 0–2 RBC | 0–2 RBC | 0–2 RBC |
IgM anti-VCA-EBV antibodies | Negative | / | Positive | / | / | / | / | / |
IgM anti-HAV antibodies | Negative | / | Positive | / | / | / | / | / |
Leptospira complement fixation test | Negative | / | Positive | / | / | Negative | / | Negative |
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Varga, N.-I.; Mateescu, D.-M.; Negrean, R.A.; Horhat, F.G.; Bagiu, I.-C.; Kodimala, S.C.; Bandi, S.S.S.; Horhat, R.M.; Horhat, D.I.; Mot, I.C.; et al. Diagnosis and Management of a Triple Infection with Leptospira spp., Hepatitis A Virus, and Epstein–Barr Virus: A Rare Occurrence with High Hepatotoxic Effect. Healthcare 2023, 11, 597. https://doi.org/10.3390/healthcare11040597
Varga N-I, Mateescu D-M, Negrean RA, Horhat FG, Bagiu I-C, Kodimala SC, Bandi SSS, Horhat RM, Horhat DI, Mot IC, et al. Diagnosis and Management of a Triple Infection with Leptospira spp., Hepatitis A Virus, and Epstein–Barr Virus: A Rare Occurrence with High Hepatotoxic Effect. Healthcare. 2023; 11(4):597. https://doi.org/10.3390/healthcare11040597
Chicago/Turabian StyleVarga, Norberth-Istvan, Diana-Maria Mateescu, Rodica Anamaria Negrean, Florin George Horhat, Iulia-Cristina Bagiu, Shiva Charana Kodimala, Satya Sai Sri Bandi, Razvan Mihai Horhat, Delia Ioana Horhat, Ion Cristian Mot, and et al. 2023. "Diagnosis and Management of a Triple Infection with Leptospira spp., Hepatitis A Virus, and Epstein–Barr Virus: A Rare Occurrence with High Hepatotoxic Effect" Healthcare 11, no. 4: 597. https://doi.org/10.3390/healthcare11040597