Tropical Infections Induced Fulminant Hepatitis in Peripartum Managed Successfully: Tales of Fate

Abstract

Tropical diseases such as malaria, dengue, intestinal helminths, schistosomiasis, leishmaniasis, and filariasis have an essential influence on the reproductive health of patients. Various cases of pregnancy loss in unexplained circumstances are a result of underdiagnosed tropical diseases. Term pregnancy complicated by tropical diseases is a challenge for the treating clinicians as these infections tend to mimic HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome and increase the chances of perinatal complications and maternal mortality. Except for tropical diseases, ever since the conception of the COVID-19 pandemic, the differentials for fever pregnancy have become extensive, and the treating clinicians need to solve the puzzle of the etiology behind these symptoms that are non-specific and might be due to both COVID-19 and tropical Infections. Prophylactic treatment for malaria is pivotal in pregnancy as immunity is decreased during pregnancy, making the patient susceptible to developing malaria-related complications. Dengue is one of the most common mosquito-borne infections found around the globe. Complications of dengue during pregnancy include pregnancy loss as well as vertical transmission of infection to the fetus. Leptospirosis, even though rare, has a wide range of complications in pregnancy ranging from fetal loss to congenital infection and oligohydramnios, thereby requiring close monitoring and prompt management during pregnancy. We report a case series of three cases where patients presented during the period of pregnancy with fulminant hepatic failure, which turned out to be a consequence of tropical diseases. All the cases were treated successfully and discharged in stable condition.