[Hepatitis E infections in the Western world].

BACKGROUND

Besides the hepatitis A and B viruses, the hepatitis E virus (HEV) is a major contributor to infectious hepatitis in developing countries. In the Netherlands, acute HEV infection is occurring with ever-increasing frequency, although it is not always immediately recognized. We present a Dutch patient who was diagnosed with hepatitis E after having returned from Spain.

CASE DESCRIPTION: A 69-year-old male patient presented with symptoms of general malaise, nausea, abdominal pain and fatigue. A gastroenterologist identified hepatitis on the basis of laboratory testing and abdominal ultrasound. Additional investigations included serological blood tests, PCR (polymerase chain reaction) testing and a histopathological analysis of a liver biopsy. Finally, the diagnosis of acute HEV infection was established; the patient recovered without further treatment.

CONCLUSION

HEV is endemic in the Western world and not merely an imported disease. Diagnostic testing for HEV should be incorporated into the standards of care for any patient suspected of having infectious hepatitis, with serological PCR-testing of HEV-RNA being an essential element.