Fulminant Hepatitis A in Intravenous-Drug Users

Excerpt

To the Editor: We recently saw a case of fulminant hepatitis A infection in a patient with a history of intravenous drug abuse. The recently reported outbreaks of hepatitis A in drug abusers (1, 2) and the apparently increased incidence of fulminant infection in this patient population suggest a need for close monitoring and aggressive care of what has previously been considered a relatively benign disease.

A 24-year-old nonalcoholic white woman at 24 weeks gestation was hospitalized with a 2-week history of fatigue, anorexia, and deepening jaundice. She had a history of intravenous amphetamine abuse, and two episodes of "infectious