Clinical profile of patients of pyrexia with hepatic dysfunction in a tertiary care hospital in Southern Rajasthan region of India

Abhishek Mistry, Yogesh Kumar Singhal, Pankaj Gupta, D. C. Kumawat


Background: Pyrexia in association with hepatic dysfunction is commonly found in clinical practice with varied etiologies like malaria, dengue, typhoid, scrub typhus, viral hepatitis, etc. The liver is frequently involved in systemic infections, resulting in various types of abnormal liver function tests. It is very important to know the frequency and pattern of abnormal liver function tests in each infection for its appropriate management.

Methods:  A complete data of all the patients admitted in medicine wards and medicine ICU from January to December 2018 were studied. One hundred and ten patients with fever with abnormal liver function tests were interviewed and presenting complaints were noted. Demographic data such as age and sex were noted. These patients underwent a thorough general physical examination and systemic examination. The findings were noted on a predesigned and pretested proforma. The selected patient underwent blood investigations related to liver functions.

Results: Most of the patients were of age group of 21 to 50 years (65 patients), 67 patients (60.91%) were males and 43 (39.09%) were females. Malaria (25.45%) and dengue (26.36%) were major etiologies. Hepatomegaly (46.36%), icterus in (45.45%) and splenomegaly (42.73%) were most common clinical signs.

Conclusions: Present study will help clinicians to identify etiological factors and clinical picture in patients of pyrexia with hepatic dysfunction.


Fever, Dengue, Hepatomegaly, Hepatic, Malaria

Full Text:



1. Axelrod YK, Diringer MN. Temperature management in acute neurologic disorders. Neurol clin. 2008;26(2):585-603.

Kluger MJ. Fever: its biology, evolution, and function. Princeton Legacy Library. Princeton University Press. 2015;218.

Herd AM. Mahadevan SV, Garmel GM editors. An introduction to clinical emergency medicine. Cambridge university press. Can Fam Physician. 2007;53(2):296-7.

Nair PS, Jain A, Khanduri U, Kumar V. A study of fever associated with thrombocytopenia. JAPI. 2003;51:1173.

Minemura M, Tajiri K, Shimizu Y. Liver involvement in systemic infection. World J hepatol. 2014;6(9):632.

Kashinkunti MD, Gundikeri SK, Dhananjaya M. Acute undifferentiated febrile illness-clinical spectrum and outcome from a tertiary care teaching hospital of north Karnataka. Int J Biol Med Res. 2013;4(2):3399-402.

Ittyachen AM, Ramachandran R. Study of acute febrile illness: a 10-year descriptive study and a proposed algorithm from a tertiary care referral hospital in rural Kerala in Southern India. Trop doc. 2015;45(2):114-7

Rani RV, Sundararajan T, Rajesh S, Jeyamurugan T. A study on common etiologies of acute febrile illness detectable by microbiological tests in a tertiary care hospital. Int J Curr Microbiol App Sci. 2016;5(7):670-4.

Ahmad S, Dhar M, Mittal G, Bhat NK, Shirazi N, Kalra V et al. A comparative hospital-based observational study of mono- and co-infections of malaria, dengue virus and scrub typhus causing acute undifferentiated fever. Eur J Clin Microbiol Infect Dis. 2016;35(4):705-11.

Mittal G, Ahmad S, Agarwal RK, Dhar M, Mittal M, Sharma S. Aetiologies of Acute Undifferentiated Febrile illness in Adult Patients - an Experience from a Tertiary Care Hospital in Northern India. J Clin Diagn Res. 2015;9(12):DC22-4.

Shelke YP, Deotale VS, Maraskolhe DL. Spectrum of infections in acute febrile illness in central India. Indian J Med Microbiol. 2017;35:480-4.

Chrispal A, Boorugu H, Gopinath KG, Chandy S, Prakash JA, Thomas EM et al. Acute undifferentiated febrile illness in adult hospitalized patients: the disease spectrum and diagnostic predictors-an experience from a tertiary care hospital in South India’. Trop Doc. 2010;40(4):230-4.

Salagre KD, Sahay RN, Pazare AR, Dubey A, Marathe KK. A Study of Clinical Profile of Patients presenting with Complications of Acute Febrile Illnesses During Monsoon. J Assoc Physicians India 2017;65(9):37-42.

Kumar A, Rao CR, Pandit V, Shetty S, Bammigatti C, Samarasinghe CM. Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, Udupi district, Karnataka. Indian J Community Med. 2010;35:386-90.

Kumar V, Kumar V, Yadav AK, Iyengar S, Bhalla A, Sharma N et al. Scrub typhus is an under-recognized cause of acute febrile illness with acute kidney injury in India. PLoS neglected tropical diseases. 2014;8(1):e2605.