Case 12-2011: A 9-Month-Old Boy with Acute Liver Failure

A 9-month-old boy was admitted to the hospital because of fever, diarrhea, and acute liver failure. He had been well, and the results of routine newborn metabolic screening were normal. Examination showed an enlarged liver that was fatty on imaging studies. Presentation of Case Dr. Jess L. Kaplan (Pediatrics): A 9-month-old boy was admitted to the hospital because of fever, diarrhea, and liver failure. The patient had been well until 2 days before admission, when lethargy, irritability, rhinorrhea, intermittent vomiting, and nonbloody diarrhea developed, with decreased oral intake. The next day, the temperature reportedly increased to 38.1°C. He was seen in a health center associated with this hospital; the temperature was 37.6°C, and the physical examination was normal. Acetaminophen and a pediatric oral electrolyte solution were prescribed for presumed viral gastroenteritis, and he was sent home. The next day, symptoms worsened; . . .