Fatal Autochthonous Hepatitis E Induced Acute on Chronic Liver Failure Presenting with Multiorgan Failure in a Non-endemic Country: Brief Review of Intensive Care Unit Management

Hepatitis E is usually a self-limiting disease that is considered rare in western countries. Outside of endemic regions, hepatitis E is seldom considered a cause of liver failure. We describe the first reported case of hepatitis E induced acute liver failure in the Caribbean island of Trinidad and the wider Caribbean; all traditionally considered non-endemic regions. The patient was a previously well young female who, upon investigation, was found to have radiographic signs suggesting underlying chronic liver disease. Subsequent testing yielded a positive hepatitis E immunoglobulin (Ig) M leading to the diagnose of hepatitis E induced acute on chronic liver failure. The patient’s condition quickly deteriorated following the expected pattern of multiorgan failure associated with the disease. She died after a six-day intensive care unit (ICU) stay.