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Rev Chil Pediatr. 2018 Aug;89(4):521-524. doi: 10.4067/S0370-41062018005000606.

Scarlet fever associated with hepatitis in pediatrics. A case report.

[Article in English, Spanish]

Author information

1
Department of Pediatrics, Jackson Memorial Hospital, USA.
2
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Miller School of Medicine, University of Miami, USA.

Abstract

INTRODUCTION:

Scarlet fever is a common illness in pediatrics caused by group A beta-hemolytic strep tococcus (GABHS), which usually occurs after an episode of pharyngitis, and has an overall excellent prognosis. Hepatitis secondary to scarlet fever is a rare complication described in adults and even less frequently in children. Our objective was to describe a case of hepatitis secondary to scarlet fever in a pediatric patient.

CLINICAL CASE:

A 12-year-old male with scarlet fever presented with a 4-day history of jaundice, dark urine, and decreased appetite. Laboratory tests revealed elevated liver enzy mes and total and direct bilirubin levels, and negative studies for hepatitis A, B and C, Epstein Barr virus, parvovirus B19, adenovirus, cytomegalovirus, human herpes virus-6, and herpes simplex virus 1 and 2. Abdominal ultrasound examination was normal.

DISCUSSION:

The pathogenesis of scarlet fever associated hepatitis remains unclear. Streptococcal pyrogenic exotoxin mediated cellular injury via cytokine production has been proposed as a possible mechanism of hepatotoxicity in GABHS infections.

CONCLUSION:

Hepatitis secondary to scarlet fever remains a rare but benign entity, with complete recovery expected over weeks to months.

PMID:
30571828
DOI:
10.4067/S0370-41062018005000606
[Indexed for MEDLINE]
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