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Abstract: A 16-year-old child had recurrent fever with abnormal liver function and decreased appetite for the past six months. During this period, she was hospitalized several times according to respiratory tract infection with poor results, and reappeared with fever for 1 week.
Basic information】Female, 16 years old
Disease Type】 Cytomegalovirus hepatitis
Hospital】The 988th Hospital of the PLA Joint Logistics and Security Forces
Date of consultation】December 2021
Treatment plan】Medication (ganciclovir capsule + compound glycopyrrolate tablets)
Treatment period】3 weeks of inpatient treatment, 3 weeks of home treatment followed by 1 year of follow-up
Effectiveness】The disease has been controlled, all indicators have recovered, and symptoms have been relieved
I. Initial consultation
The earliest onset of fever was unexplained, and the blood tests were normal. The local hospital gave symptomatic treatment for the common cold for 3 days and then the temperature was normal. The child was discharged from the hospital after receiving symptomatic treatment for infectious fever and liver damage, which recurred four times during the period. The child was under great psychological pressure, fearing that he had an incurable disease on the one hand and his schooling on the other. After admission to the department, he was tested for blood, urine, stool, hepatitis B, hepatitis A, hepatitis C, hepatitis E antibodies, biochemistry, respiratory pathogens, autoimmune antibodies, immunoglobulins, complement, autoimmune hepatitis antibodies and other related tests were normal. The abdominal ultrasound examination showed no abnormalities in the liver, gallbladder and spleen, and no enlargement of abdominal lymph nodes, so the cytomegalovirus was considered to be a previous infection with no clinical diagnostic value. Liver function tests showed TBIL: 14.8umol/L, DBIL: 9.1umol/L, ALT: 206U/L, AST: 118U/L. The diagnosis of cytomegalovirus hepatitis was made based on the relevant tests, and hospitalization was recommended for comprehensive treatment.
II. Treatment history
The child’s normal life and study were significantly affected due to repeated low fever and intermittent liver function abnormalities in the past six months, and the child was also under great psychological pressure and had obvious depressive mood. The child’s body temperature returned to normal, and the symptoms of fatigue and loss of appetite gradually disappeared, and the liver function improved significantly after a half-month review.
III. Treatment effect
After 3 weeks, the liver function was normal and there were no significant abnormalities in other examinations, so the child was discharged from the hospital to continue treatment. After discharge, it is recommended to continue to take ganciclovir capsules, and the child is advised to pay attention to rest, take medication on time, review liver and kidney function after 3 weeks, strengthen nutrition, enhance the body’s ability to resist disease, abstain from alcohol, avoid spicy and cold food. The child was advised to take rest regularly, to take a follow-up check of liver and kidney function after 3 weeks, to enhance nutrition, to strengthen the body’s resistance to disease, to abstain from alcohol, to avoid spicy and cold food, and to eat more fruits, vegetables and vitamin-rich foods. After 3 weeks of home treatment, the child’s fever and malaise disappeared, liver function returned to normal, and the child’s mental and physical strength returned to normal. Since the child had recurrent fever and abnormal liver function within six months, the child was followed up for more than one year, and there has been no recurrence.
IV. Notes
We are glad that after treatment the child’s condition has been controlled and clinically cured, the indicators have recovered and the symptoms have been relieved. The child is usually in good physical condition and has no discomfort, but this time after the onset of recurrent fever and weakness, accompanied by liver function abnormalities resulting in loss of appetite, the child is depressed and sad, the diagnosis of the disease was clarified after coming to our hospital, and the comprehensive treatment is effective. Prevent recurrence and reinfection.
1, regular work and rest and good living habits.
2, eat more fruits, vegetables and other vitamin-rich food, more milk, lean meat, eggs to increase the body resistance.
3, maintain a good state of mind, happy mood, do not stay up late, tired, appropriate exercise.
4.If you are not feeling well, go to the hospital actively to avoid delaying the disease and aggravating the symptoms.
V. Personal insight
Cytomegalovirus is commonly found in the population and the population is generally susceptible. However, only a minority of people will develop the disease and show clinical symptoms, usually most people do not develop the disease, if the onset of the disease will be more serious, symptoms to fever, cough, liver and spleen damage. The disease generally does not appear to be transmitted from person to person, the clinical appearance of liver damage is also relatively rare, so even if the infection does not need to be overly nervous, if there are uncomfortable symptoms, to correctly recognize, and promptly go to the regular hospital, active treatment, usually the same as the patient can achieve very good results.