Leptospirosis and Severe Malaria presenting in a male with Fulminant Hepatic Failure from Wilson's Disease

Abstract

An unusual co-finding of two potentially life-threatening infections that is leptospirosis and malaria complicating to fulminant hepatic failure with an underlying Wilson's disease. As for from what we have learned and encountered in our clinical years, a co-existence of four fatal conditions has not been seen. An 18-year-old Asian male presented with fever, rigors, vomiting, jaundice, and behavioral changes. Following clinical and laboratory evaluation he was diagnosed with leptospirosis, complicated malaria, and fulminant hepatic failure. He received treatment for both infections and showed significant improvement. Furthermore, he was also diagnosed with Wilson's disease. Therefore, fulminant hepatic failure in a young adult should alarm the physician to suspect a primary liver pathology as Wilson's disease for the early diagnosis and prompt management.