Acute Liver Failure in a Pediatric Patient with Disseminated Tuberculosis

Excerpt

A seven-year-old male presented to the emergency department of a local hospital with sudden onset of mental status changes and jaundice. He had previously been a healthy child who was born and spent his first years of his life in India. He had normal growth and development. He was fully immunized and had also received the Bacillus Calmette–Guérin (BCG) vaccine. His past and family medical history was unremarkable, with the exception that his mother had been successfully treated for isoniazid (INH)-resistant tuberculosis (TB) three years previously. At that time, the patient had 14 mm of induration after a tuberculin skin test, and he and other members of the household were treated for 9 months with rifampin. His chest X-ray remained normal. He had not been previously hospitalized or had any previous surgery. The patient and his family moved to California’s Central Valley several years before admission, and had not traveled since emigrating. The patient was an only child, and the family lived in a household with several healthy relatives and no pets. He was transferred to Stanford University Medical Center for potential liver transplantation. …