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Previous Volume 358:1604-1613 April 10, 2008 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 45-year-old man was admitted to this hospital for orthotopic liver transplantation. The patient had been well until the age of 18 years, when a diagnosis of non-A, non-B hepatitis was made after a 1-month episode of jaundice; the source of exposure was thought to be tattoos. Jaundice recurred intermittently thereafter. Six years before admission, the episodes became more frequent and severe, and chronic pruritus developed. Serologic testing disclosed antibodies to hepatitis C virus (HCV) and hepatitis B virus (HBV) core and surface antigens; tests for hepatitis B surface antigen and antibodies to hepatitis A were negative. The patient began . . . [Full Text of this Article]

Differential Diagnosis

Causes of Mental-Status Changes after Liver Transplantation

Risk Factors for Infection in Allograft Recipients

Infection in the Early Post-Transplantation Period

            Reactivation of Infection in the Recipient

            Donor-Derived Infections

CNS Infections

Invasive Fungal Infection and Cryptococcal Meningitis

Clinical Diagnosis

Dr. Jay A. Fishman's Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis

Source Information

From the Massachusetts General Hospital Transplant Center (J.A.F.); the Transplant Infectious Disease and Compromised Host Program (J.A.F.) and the Departments of Radiology (R.G.G.) and Pathology (J.A.B.), Massachusetts General Hospital; and the Departments of Medicine (J.A.F.), Radiology (R.G.G.), and Pathology (J.A.B.), Harvard Medical School — all in Boston.

This article has been cited by other articles:

• Antinori, S., Corbellino, M., Joy, M., Fishman, J. A., Gonzalez, R. G. (2008). Case 11-2008: Mental-Status Changes after Liver Transplantation. NEJM 359: 207-209 [Full Text]  
• Seton, M., Pless, M., Fishman, J. A., Caruso, P. A., Hedley-Whyte, E. T. (2008). Case 18-2008 -- A 68-Year-Old Man with Headache and Visual Changes after Liver Transplantation. NEJM 358: 2619-2628 [Full Text]