Liver involvement in infectious diseases

EBV

 For more information see EBV.

• hepatomegaly, liver tests are routine
• often occurs in pneumococcal pneumonia and enterovirus diseases, parainfectious liver disease
• mild elevation of ALT is also in erythema migrans in Lyme disease

HSV, VZV

 For more information see Herpesviridae.

• they can damage the liver, especially in people with reduced immunity

Malaria

 For more information see Malaria.

Dengue fever

'Dengue fever' is a viral disease caused by Flavivirus (Arboviruses) transmitted by mosquitoes. It occurs in tropical Asia, Africa and Central and South America. It mainly affects young people, including children.

The incubation period is 3-7 days, then a sudden febrile condition lasting 3-6 days begins A two-phase process is common. The first phase is accompanied by "high fever and persistent myalgia and arthralgia" ( breakbone fever ). During the second phase, a "maculopapular rash" usually appears, which is most pronounced on the torso, without affecting the soles and palms. At the same time, the cervical nodes enlarge. Complications can be myocarditis or nervous system damage.

'Hemorrhagic form' is manifested by bleeding on the skin, may be accompanied by ascites, vomiting, abdominal pain; progression is manifested by hypotension, hypovolemia, and shock. The cause is a recurrent infection with another serotype of the virus.

Symptoms of Dengue fever

Diagnostic

Specific antibody titer.

Treatment

Symptomatic.

Prognosis

Usually good, except the hemorrhagic form.

CMV

 For more information see CMV.

• the source of the infection are sick patients or carriers – they excrete the virus in saliva and urine
• it spreads horizontally (by air, contact, breast milk, transfusion), and persists vertically in the body
• acquired CMVosis occurs asymptomatically or as mild influenza in immunocompetent individuals, rarely as heart attack
• hepatitis occurs after transfusion or in immunocompromised individuals
• congenital CMVosis due to infected mother and/or infected milk
• either miscarriage or congenital disorders of the CNS, heart, or eyes

Diagnosis

• virus isolation, serology

Therapy

• ganciclovir (antiviral)

Leptospirosis

Leptospirosis is an infectious disease caused by the bacterium Leptospira interrogans . It is an anthropozoonosis.

Etiology

Leptospira belong to the Spirochete family . They are long, motile, strictly aerobic, and spiral bacteria. They do not stain well, but we can observe them using dark microscopy. Hemolysin, wall lipopolysaccharide or phospholipases are involved in it's pathogenicity. They are widespread in the wild and also colonize many animals, some of which excrete them in the urine.

Epidemiology

Infection most often occurs by ingesting infected water or food, but a person can also become infected by contact with an animal or, for example, by a penetrating injury to the skin. The infectious dose is small, sometimes just a few individual bacteria are enough. The incubation period is about 6-20 days.

In the Czech Republic, leptospirosis occurs mainly after floods.

Clinical picture

The course of the disease varies according to the nature of the infectious strain. We distinguish between icteric and anicteric forms.

Icteric form

• Presents as Weil's syndrome - jaundice, kidney damage, meningeal syndrome and bleeding;

• jaundice, myalgia, headache;
• a marked disparity between high bilirubin and relatively low ALT ;
• the patient is more at risk of kidney failure and bleeding.

Anicteric form

• more common , similar to the flu or seasonal meningitis , has a milder course;
• we find signs of liver and kidney damage;
• it heals without consequences.

Diagnosis

• Based on epidemiological history, significant clinical manifestations;
• specific Ig in serum;
• dark microscopy.

Therapy

• Anicteric forms are treated only symptomatically;
• more severe treated with penicillin or ampicillin ;

References

Source

• BENEŠ, Jiří. Studijní materiály [online]. [cit. 2010]. <http://jirben.wz.cz>.

• HAVLÍK, Jiří. Infektologie. 2. edition. Avicenum, 1990. ISBN 80-201-0062-8.

• LOBOVSKÁ, Alena. Infekční nemoci. 1. edition. Karolinum, 2001. ISBN 80-246-0116-8.