Hepatitis
Pathology (NIH; PubMed 2010): A condition resulting in inflammation of the liver. Most commonly caused by caused by viral infection, including Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D & Hepatitis E. Hepatitis can also be caused by autoimmune disease, or chronic drug abuse through alcohol or medications.
Demographics (NIH; PubMed 2010): Because there are many different forms of hepatitis. The non-viral causes are common with drug abuse that can occur at any age, while the autoimmune cause is unknown. Hepatitis A and E are spread through exposure to fecal matter. Hepatitis B is spread through the blood by sharing needles or sexual contact. Hepatitis C is also spread by blood and is most commonly associate with blood transfusions. Hepatitis D is associated with Hepatitis B in order to co-infect the individual.
Clinical Presentation (NIH; PubMed 2010): Sense of fullness, anorexia, nausea, vomiting, skin or nail changes (jaundice, bruising, spider angioma, palmar erythemia or white nails), dark urine, light colored feces, ascites, oliguria, right upper quadrant pain, myopathy, possible neurological symptoms (confusion, sleep disturbances, muscle tremors, hyperactive reflexes, asterixis or bilateral carpal tunnel), pallor, fatigue or gynecomastia.
Differential Diagnosis: A thorough patient history, with focus on reviewing all red flags and constitutional signs and symptoms to check for systemic illness. If hepatitis is suspected questions should also include drug abuse, sexual activity, exposure to fecal matter or blood, traveling to foreign countries or ever having a blood transfusion (Goodman & Snyder, 2007). Examination should also include palpation of the liver, observation for ascites or jaundice (skin and eyes), test for asterixis and positional changes to see if the patient’s pain subsides with movement.
Bottom Line: Refer out
Hepatitis can be life threatening and if suspected should be referred immediately to a physician.
Demographics (NIH; PubMed 2010): Because there are many different forms of hepatitis. The non-viral causes are common with drug abuse that can occur at any age, while the autoimmune cause is unknown. Hepatitis A and E are spread through exposure to fecal matter. Hepatitis B is spread through the blood by sharing needles or sexual contact. Hepatitis C is also spread by blood and is most commonly associate with blood transfusions. Hepatitis D is associated with Hepatitis B in order to co-infect the individual.
Clinical Presentation (NIH; PubMed 2010): Sense of fullness, anorexia, nausea, vomiting, skin or nail changes (jaundice, bruising, spider angioma, palmar erythemia or white nails), dark urine, light colored feces, ascites, oliguria, right upper quadrant pain, myopathy, possible neurological symptoms (confusion, sleep disturbances, muscle tremors, hyperactive reflexes, asterixis or bilateral carpal tunnel), pallor, fatigue or gynecomastia.
Differential Diagnosis: A thorough patient history, with focus on reviewing all red flags and constitutional signs and symptoms to check for systemic illness. If hepatitis is suspected questions should also include drug abuse, sexual activity, exposure to fecal matter or blood, traveling to foreign countries or ever having a blood transfusion (Goodman & Snyder, 2007). Examination should also include palpation of the liver, observation for ascites or jaundice (skin and eyes), test for asterixis and positional changes to see if the patient’s pain subsides with movement.
Bottom Line: Refer out
Hepatitis can be life threatening and if suspected should be referred immediately to a physician.