Fulminant Emphysematous Hepatitis – A Rare Cause of Septic Shock

Emphysematous hepatitis is a rare entity characterized by the replacement of hepatic parenchyma by gas, leading to acute liver failure. Often it occurs in patients with diabetes mellitus, liver disease or a recent history of abdominal surgery. We present a case of emphysematous hepatitis in a 74-year-old man with no recognizable risk factors. Despite the early broad-spectrum antimicrobial therapy and supportive care, the condition progressed to a fatal outcome, as seen in other case reports. Early recognition of this condition and rapid and aggressive management may improve patient outcomes. LEARNING POINTS: Emphysematous hepatitis is a rare condition characterized by replacement of hepatic parenchyma by gas. The diagnosis of emphysematous hepatitis requires imaging, preferably a computed tomography scan. Emphysematous hepatitis warrants awareness among clinicians for early diagnosis and rapid and aggressive management.