Psychotic Symptoms During Hepatitis A Infection: A Rare Case Report from Iran

Abstract

Psychosis, a relatively common condition that affects 3%-5% percent of the population, occurs in a variety of diagnostic contexts. Various medical conditions may lead to the development of psychotic symptoms. To date psychotic disorders due to infection with hepatitis A virus (HAV) have  been  rarely reported.

In this paper, we described an acute psychotic disorder in an 18-year-old male diagnosed with  hepatitis A infection . He presented with complaints nausea, vomiting, fever, constipation and abdominal pain of a one week duration. The patient denied a history of substance abuse. Neurological evaluation was normal. Brain CT scan was remarkable for suspicious  hyperdense lesions in the basal ganglia, however the EEG was normal. He had visual  hallucinations, persecutory delusion, disorganized  behavior, personality changes, sleep  disturbances, and disorganized  speech.  A psychiatrist diagnosed the patient with psychotic  disorder due  to HAV and treated him with antipsychotic  medications. Following the decline in liver  enzyme  levels and after several days, the patient became clinically well with regression of his psychiatric signs and schizophrenia-like symptoms.

We believe this may be the first reported case of an acute psychotic disorder during active HAV infection. Based on the data we have collected from several references we conclude that the most probable reason for this accompaniment is a type of comorbidity between acute psychotic disorder and HAV infection.