A 64-year-old man with complaints of general fatigue and high fever was admitted because of liver dysfunction. He had a history of eating raw oysters 2 weeks before. His laboratory data on hospital day 1 were as follows: total bilirubin (TB), 1.16 mg/dl; aspartate aminotransferase (AST), 1870 IU/L; alanine aminotransferase (ALT), 1042 IU/L and PT activity, 77.6%. On the second day, his liver injury worsened rapidly on the basis of the following values: TB, 3.02 mg/dl; AST, 5400 IU/L; ALT, 2945 IU/L and PT activity, 47.5%. The risk of hepatic encephalopathy development in acute liver injury on the second day was calculated 13.5%; therefore, high-dose corticosteroid therapy was administered. The liver injury improved. Later, the etiology of liver injury was found to be hepatitis A infection. Genotype IIIA is often found in South Asia and is different from the genotype IIIA clusters found in the outbreak in Korea.
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