| Summary points: | An 18-year-old Pakistani male presents with a 2-day history of fever, cough, headache, and vomiting. Clinical examination, extensive laboratory data, and chest radiograph are described. His condition gradually deteriorated and on day 7, he developed multi-organ dysfunction. Echocardiography, repeat testing, and treatment are described. The authors discuss this extremely rare case of fulminant hepatitis with multiorgan dysfunction including liver failure, hepatic encephalopathy, renal failure, pleural effusion, pericardial effusion, and haematologic dysfunction as a sequale of this infection in an otherwise healthy male. |