Acute Liver Failure in a Patient With Minimal Comorbidities Due To Influenza A (H1N1) Infection: A Case Report

The H1N1 influenza strain originated in Mexico and the Southwestern United States in March of 2009 and was caused by a new variant of influenza A virus. Some studies have revealed that renal and liver damage can occur in rare cases of influenza H1N1 virus. Acute liver failure in H1N1 virus is one of the lesser-known pathologies. However, despite dealing with this illness for an extended period of time, there are still unknowns involved. Our case below brings new data to the realm of multi-organ failure associated with the H1N1 virus. A 39-year-old morbidly obese female Hispanic patient presented to our hospital originally for myalgia, fever, chills, headache, nausea, vomiting, and a cough for 1 day. The patient had no pertinent medical history and denied a recent travel history or family history of a similar illness. The patient tested positive for influenza A in the emergency department (ED) and was discharged home with supportive measures. Her symptoms worsened, and she returned to the ED 3 days later with chest pain, fever, vomiting, and some bloody emesis. Here, we report a case of influenza A (H1N1) in a relatively healthy Hispanic woman with minimal comorbidities, which ultimately resulted in acute respiratory distress syndrome, septic shock, disseminated intravascular coagulopathy, and multi-organ failure. This case illuminates the importance of thorough clinical evaluation, comprehensive history-taking, timely counseling regarding over-the-counter medications, and interpreting laboratory results in diagnosing and managing rare but critical conditions, as noted in adult populations. Healthcare professionals can be better equipped to consider and recognize Reye's syndrome as a differential diagnosis in adult patients presenting with similar symptoms.