At your clinic, 44-year-old Colin comes to the office because of abdominal pain for 3 months.
He has not been to a physician in 10 years and has been using IV drugs since he was 17.
He does not drink alcohol and has no significant family history.
His temperature is 38.2°C or 100.76°F, pulse is 98/min, respirations are 19/min, and blood pressure is 126/84 mmHg.
Physical examination shows a large distended abdomen, yellow sclera, palmar erythema, and spider angioma on his abdomen and extremities.
Lab results reveal the following: Hepatitis A IgM antibody negative, Hepatitis B surface antigen negative, Hepatitis B surface antibody positive, Hepatitis B core antibody negative, and HCV antibody positive.
At the same time, a 32-year-old pregnant individual named Megan comes to the emergency department because of vomiting and fever.
The patient worked as a global health nurse and her medical history is relevant for recent traveling to Nepal.
Physical examination shows yellowing of the skin and sclera, right upper quadrant tenderness, and hepatomegaly.
Her temperature is 38.5°C or 101.3°F, pulse is 97/min, respirations are 15/min, and blood pressure is 120/75 mmHg.
Both Colin and Megan have viral hepatitis, which is inflammation of the liver parenchyma caused by hepatitis viruses A, B, C, D, or E.
Based on the duration of symptoms, hepatitis can be acute, which lasts less than 6 months, or chronic, which lasts more than 6 months.
Individuals with acute viral hepatitis typically present with fatigue, malaise, nausea, vomiting, anorexia, low-grade fever, jaundice, dark urine, and right upper quadrant tenderness; whereas individuals with chronic viral hepatitis can be asymptomatic or they can present with non-specific symptoms such as malaise and fatigue.
