Hospital stay reveals high liver enzymes result of unknown virus?

[randarmax]

With repeated fever/chills and a feeling of a 50lb weight on my chest I went to ER.  Diagnosed as pleurisy.  Given 750mg levaquin, 500mg Naproxen.  Took meds, for 2 days but chest pain persistent, saw personal physician who prescribed hydrocodone.  Then stronger pain began under right pectoral muscle along with nausea- surely due to not enough food on my stomach.  Went back to ER and was admitted to hospital.  All types of scans/tests/ultrasounds were performed on my chest and abdominal area.  Doctors said all my internal organs were functioning well and looked okay- except my liver was enlarged/inflamed.  They ruled out hep A, B and C and mono.  Blood work revealed that my liver enzyme count was rising from 1.8 on day one to 10. on day 5.  They also noticed a slight bit of fluid in my lungs, but thought it related to the pleurisy.  For 7 days I had experienced fever between 100 and 103.x, with consistent sweats and jaundice.  Although I had little appetite, I experienced regular constipation.  They gave me lactulose for that.  After 48 hours fever-free, but still with high enzyme count in my liver, the doctors admitted "all we can speculate is that this is a virus of some kind we have never seen."  So they sent me home.  Upon leaving hospital the doctor told me that my liver enzyme levels were slightly rising- but he felt they were leveling off and that I had turned the corner.  Today is day 1 out of the hospital.  I still have a little nausea, constipation, and slight jaundice.  I experienced one episode of light grade fever overnight.  I've felt pretty yucky all day and now have noticed a rash in spots on my stomach, sides, and back- small red dots with big splotchy white areas around them.  I've taken 2 Ducolax 5mg tabs to help with the constipation, diet since hospital includes 1- 6" stk&chse sub (i know, but my wife bought it for me when she picked me up from hospital and I was famished), fruit, OJ, H2O, cheerios, frosted flakes (both bowls with skim milk).  Has anyone heard of this before?  It's the worst ordeal I've ever gone thru health-wise.

[Kevin Pho, MD]

Difficult to say what it is without reviewing the studies.  

There are indeed many viruses that can lead to elevated liver enzymes and hepatitis.  Many of the major ones have likely been tested for in the hospital.

If the liver enzymes continue to rise, and there is evidence of jaundice, then further tests can be considered.  A liver biopsy, for instance, can be considered for a more definitive diagnosis.  This is normally considered if the ALT is persistently 3x the upper limit of normal.

You can also consider looking at the biliary ducts for any blockages.  This can be done with an MRCP.  

These options can be discussed with your personal physician, or in consultation with a gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[randarmax]

Let me add I am a 43 yr white male, do not smoke or take drugs, drinks very little, perhaps 1 drink a month.  At this writing my rash I spoke of has spread predominantly over my chest, back and sides, itches tremendously.  It's like the poison of whatever was ailing me the past several days in the hospital is coming out my skin.  Have a dr. appt. at 10:45 a.m. this morning.  Exams done while in hospital (in order)were:  chest x-ray, d-dime, CT-scan chest, VQ-scan, x-ray stomach, ultrasound of heart, ultrasound of abdominal, CT-scan abdominal, hida-scan.  Several blood tests for pneumonia, flu, hepatitis A, B, C, mono, hiv all of which came back neg, other than the high liver enzymes and low wbc count, nothing seemed out of order.    

[randarmax]

My primary care physician says my rash may be allergic reaction to something within the ducolax, or some toxicity being released by germs from the virus as they die.  Either way he gave me zyrtec (sp?) and instructed me to take benedryl at night if needed.  We did another blood draw to see where my levels were on my liver.  Prescription:  Easy-does-it, bland diet.  Watch for worsening conditions.

[women_2020]

This might help you out , if you want to come in and read, the site can be found here http://health.groups.yahoo.com/group/Pancreatitis_sphincterofoddi/

[steem65]

I too, developed red spots with splotchy white areas around them on the day I was in the sitting room to see a hematologist. When he was examining me, he saw those spots but didn't comment. My blood is abnormal since my platelets and RBC are quite high. I was diagnosed of having polycythemia vera. Bone marrow biopsy, pcr for JAK2 and BCR/ABL showed that positive. I also can feel pain in my lower rib cage ( sometimes left and sometimes on the right side ) and also on the left and right lower abdomen just above the groin. I had hernia operation on both sides on the same spot where the pai is now. Could hernia be the cause due to reoccurrence? I ust had echography to check sizes of my organs ( liver, spleen, pancreas, etc). They are all in normal size except my spleen which is a bit swollen which is due to viscousity of my blood an abnormal hemoglobin rate.