Treatment of Yellow Fever with Severe Liver Failure (Hepatic Organ Dysfunction)

Clinical Scenario

This protocol applies to patients with severe yellow fever complicated by liver failure — specifically hepatic organ dysfunction. Hepatic involvement at this severity requires targeted pharmacological management beyond general supportive care.

Liver Failure in Yellow Fever

Liver failure is a recognised severe complication of yellow fever. Specific pharmacological support for hepatic dysfunction is indicated in patients with probable or confirmed yellow fever.

Note that lactate is not useful for fluid monitoring in the context of liver failure, including in yellow fever.

Treatment Approach

Current evidence supports the use of intravenous N-acetylcysteine in patients with liver failure due to probable or confirmed yellow fever, administered according to an established protocol.

The full regimen and administration details are available in the complete protocol below.

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References

WHO suggests the use of intravenous N-acetylcysteine in the treatment of patients with liver failure due to probable or confirmed yellow fever.

Lactate is not useful for fluid monitoring in the context of liver failure, including yellow fever.

This recommendation concerns N-acetylcysteine as an intravenous medication (200 mg/mL, in a 10 mL ampoule).

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