Fulminant Hepatitis in Primary Human Herpesvirus-6 Infection

To the Editor: Liver damage in primary human herpesvirus-6 infection has been reported in infants^1,2 and adults.^{3 4 5} All patients had a benign, self-limited course except one infant with fatal fulminant hepatitis.¹ We describe here an adult with fulminant hepatitis associated with lymphadenopathy and marked atypical lymphocytosis presumably caused by herpesvirus-6 infection. A 29-year-old man was admitted to our hospital on October 17, 1989, with fever, jaundice, skin rash, and lymphadenopathy, which had developed 10 days earlier. The bilirubin concentration (2.4 mg per deciliter), aminotransferase activities, and prothrombin time (18 percent) confirmed hepatic involvement. Generalized lymphadenopathy with leukocytosis (33,100 per.