Scarlet fever associated with hepatitis in pediatrics. A case report

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Abstract

Introduction: Scarlet fever is a common illness in pediatrics caused by group A beta-hemolytic streptococcus (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 enzymes 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.

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Panchoo, A. V., Saps, M., & Rivera, E. D. R. (2018). Scarlet fever associated with hepatitis in pediatrics. A case report. Revista Chilena de Pediatria, 89(4), 521–524. https://doi.org/10.4067/S0370-41062018005000606

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