Epstein-Barr virus and acute liver failure: an exceedingly rare amalgamation

Epstein-Barr virus (EBV) associated acute liver failure (ALF) is an exceedingly uncommon event. Despite this, EBV-associated ALF has a very high fatality rate. When looking at the number of reported cases of EBV-associated ALF requiring an emergency liver transplant, we see even fewer numbers. This presents challenges to clinicians in the diagnosis, awareness and appropriate case management. There is limited information in the medical literature about the hepatic demonstration and complications of EBV.

An unusual cause of obstructive jaundice

Cryptococcus neoformans is an opportunistic fungal infection that mainly affects immunocompromised patients with or without HIV and can only be seen infrequently in the immunocompetent host. Presentation can be with pneumonia, meningitis or widely disseminated disease. We report the case of a 65-year-old man who presented with obstructive jaundice and weight loss. He had been evaluated at another institution where surgery was offered to him for a presumed diagnosis of cholangiocarcinoma.

Cytomegalovirus colitis: an unusual cause of diarrhoea in the immunocompetent

Cytomegalovirus (CMV) colitis is rarely reported in the immunocompetent adult and is often associated with inflammatory bowel disease (IBD), particularly ulcerative colitis (UC). An index of suspicion in the appropriate setting is vital to diagnosing the condition. Undiagnosed CMV colitis has a significant morbidity. A review of the natural history and diagnosis of CMV is followed by a discussion of the incidence, outcome and possible treatment of CMV in the immunocompetent patient.