American Journal of Clinical and Experimental Medicine 2014; 2(1): 1-3 Published online December 30, 2013 (http://www.sciencepublishinggroup.com/j/ajcem) doi: 10.11648/j.ajcem.20140201.11 Association of acute hepatitis a and brucellosis in two cases Mehmet Selçuk Bektaş 1, 3, * , Fesih Aktar 2, 3 , Avni Kaya 3 , Hayrettin Temel 3, 4 , Muhammed Akıl 3, 5 1 Lokman Hekim Van Hospital, Van, Turkey 2 Diyarbakir Obstetrics and Children Hospital, Diyarbakir, Turkey 3 Department of Pediatrics, Yuzuncu Yil University Faculty of Medicine, Van, Turkey 4 Gebze Fatih State Hospital, Kocaeli, Turkey 5 Siverek State Hospital, Sanliurfa, Turkey Email address: selcukbektas008@gmail.com (M. S. Bektaş) To cite this article: Mehmet Selçuk Bektaş, Fesih Aktar, Avni Kaya, Hayrettin Temel, Muhammed Akıl. Association of Acute Hepatitis a and Brucellosis in Two Cases. American Journal of Clinical and Experimental Medicine. Vol. 2, No. 1, 2014, pp. 1-3. doi: 10.11648/j.ajcem.20140201.11 Abstract: Several damage rate occurs in liver during acute infections according to the infection agent. The exposure of the patient to two different infection causes at the same time is another situation complicating the diagnosis of infectious diseases. Hepatitis A virus and brucella are two factors that are observed from the childhood in developing countries as ours and presenting different pattern. Serological tests are used to benefit from differential diagnosis. In this study, the cases of hepatitis A and brucella co-infection in spite of the different contamination ways has been presented. Keywords: Hepatitis a Virus, Brucellosis, Co-Infection 1. Introduction Hepatitis A (HAV) is a frequently observed world-wide infection and almost contaminating by fecal-oral ways. It is widely observed in people living in bad hygienic conditions and with limited revenues and may create epidemic (1). Hepatitis A infection is the most frequent cause of childhood hepatitis (2). Hepatitis A infection is usually accompanied with inappetit, fatigue, nausea, vomiting, diarrhea, stomachache, constipation and rarely by meningeal irritation. In half of the cases, there is fever during 2-3 days. The liver is big and painful. Splenomegaly may be observed in 20% of the patients. Brucella infection presents a clinic pattern similar to viral hepatitis and is rarely accompanied with liver failure (3). Fever, hepatosplenomegaly, jaundice, medium increase in liver enzymes and pronounced increase in alkaline phosphatase are typical in brucella infection (4). The exposure of the patient to two different infection causes at the same time is another situation complicating the diagnosis of infectious diseases. The patterns leading to acute hepatitis are known but this situation covers the factors infecting in the same way. In this study, we presented two cases for which HAV and brucella co-infection have been diagnosed in spite of the different contamination ways and brucella co-infection have been diagnosed in spite of the different contamination ways. 2. Case Report 1 A four year-old male patient applied to the hospital for high fever, shivering, arthralgia, nausea, vomiting and stomachache, jaundice in skin and eyes and darkening in urine. There was no particularity on his and family history. There was no history of drug utilization lately. On physical examination, the general situation was normal, the consciousness was open. Sclera and skin were icteric. A painful and 5 cm liver and 3 cm spleen have been observed in abdomen examination. Traube was closed. The neurological examination was normal. Hemoglobin 12.6 gr/dl, leucocytes 8600/mm³, thrombocyte 178000/mm³ in laboratory analyses. The other values were as follows: Aspartate aminotransferase (AST) 1350 U/L (normal range: 8-46), alanine aminotransferase (ALT) 2218 U/L (normal range: 7-46), gamma glutamil transpeptidase (GGT) 176 U/L (normal range: 11-80), alkaline phosphatase (ALP) 483