Correct!
1. Adenoviral hepatitis
There are a number of viral inclusions on the liver biopsy (Figure 4).
Figure 4. Liver biopsy showing multiple viral inclusions (arrows).
Viral inclusions are nuclear or cytoplasmic aggregates of stainable viral capsid proteins. They are a nonspecific finding and can be seen in a number of viral diseases. These in the liver are very similar to those observed in the lung.
In this patient’s case the presence of viral inclusions is consistent with hepatitis complicating his known adenoviral infection.
In a series of 89 definite cases of adenoviral hepatitis, 43 (48%) were in liver transplant recipients and 19 (21%) in BMT recipients. Ninety percent of the cases presented within 6 months of transplant. Only 27% survived with only 2 of the 19 BMT recipients surviving.
Which of the following are therapeutic options?