Early Post-liver Transplantation Fever in a Child

A2.5-year-old girl underwent orthotopic liver transplantation (OLT) for cirrhosis secondaryto progressive familial intrahepatic cholestasis. She was well until five days posttransplantationwhen she developed fever (up to 39 °C). At that time, she was receivingtacrolimus, cellcept and prednisolone. Her laboratory findings revealed a serum ALT of 70 IU/L,AST of 75 IU/L, Alk-P of 560 IU/L, and a total bilirubin of 2 mg/dL with a direct bilirubin of 0.7mg/dL. Epstein-Barr virus capsid antigen and cytomegalovirus IgM were negative. Blood culturefor fungus and bacteria were also negative. Photomicrograph of the biopsy is shown in Figure 1.