ACUTE HEPATITIS E INFECTION PRESENTING AS FEVER AND MACULOPAPULAR RASH: A CASE REPORT

Extrahepatic manifestations of hepatitis E infection rarely include rash. We report a case of acute hepatitis E infection with rash. A 28-year-old Thai man presented with fever for 6 days and generalized maculopapular rash for 1 day. The laboratory results showed transaminitis with the peak alanine aminotransferase level of 2,850 U/l. Common etiologies of fever with rash such as other tropical diseases, systemic viral infections and drug induced hepatitis were investigated and excluded by absence history of drug usage and negative PCR and serology for dengue, scrub typhus, murine typhus or leptospirosis. A diagnosis of acute hepatitis E infection was made with a positive serum hepatitis E RNA. Rash is an uncommon extrahepatic manifestation of hepatitis E infection. Hepatitis E infection should be considered in the differential diagnosis of acute hepatitis with a maculopapular rash.