This is a different expert.
I have a different opinion. While hepatitis can be a cause here, the bilirubin does not seem to be markedly raised, your brother should definitely get the hepatitis screens done but at the same time this could also be due to another cause. Many viral infections or for that matter bacterial infections can also cause transient increase in the liver enzymes. It is possible that these deranged liver enzymes are not the actual disease itself but a consequence of another pathology. A fever of 105 is very concerning, and i dont believe that with this high a fever he should have been discharged. A fever this high should be investigated while the person is kept in the hospital, secondly are any of his other tests deranged? Specifically renal function tests as well as his CBC. This could give a clue whether this is a infection or not.
If your brother lives in an area with hot temperature or works outside a lot, then a heat stroke could explain the raised liver enzymes as well as the high grade fever. This would cause symptoms like drowsiness, dizziness, dry skin, altered mental status, dark colored urine etc.
In short this is something which should be further investigated, while hepatitis can be a cause here, im more concerned about the high grade fever which he has had. if he is still spiking this high a fever then he needs to go to the ER again and possibly get blood, urine cultures done as well. It would be helpful if you could give me more information about any other symptoms he might have developed? like abdominal pain, vomiting etc?
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