Hepatitis A

Patient was diagnosed to have hepatitis because of the clinical manifestations such as the
presence of dark urine, urticaria on different parts of her body, and weight loss of 5lbs over a
month. In addition, her travel history to an endemic area (Puerto Rico) is a common source of
infection for adults from non-endemic areas. HAV is an acute onset commonly affects children and
young adults. Incubation period is about 15 to 45 days and is usually transmitted from fecal to oral
route. Its severity is usually mild and has an excellent prognosis. The prodromal symptoms of acute
viral hepatitis are systemic and quite variable. Person to person spread of HAV is enhanced by
poor personal hygiene and overcrowding. There were large outbreaks as well as sporadic cases
have been traced to contaminated food, water, milk, frozen raspberries and strawberries, green
onions imported from Mexico, and shellfish. More recently recognized epidemiologic foci of HAV
infection include child care centers, neonatal intensive care units, promiscuous men who have sex
with men, injection drug users and unvaccinated close contacts of newly arrived international
adopted children most of which came from countries with intermediate to high hepatitis A
endemicity.
Constitutional symptoms include:

 Anorexia
 nausea and vomiting
 fatigue
 Malaise
 Arthralgias
 Myalgias
 Headache
 Photophobia
 Pharyngitis
 cough
 coryza may precede the onset of jaundice by 1–2 weeks.
 nausea, vomiting, and anorexia
- are frequently associated with alterations in olfaction and taste. A low-grade fever
between 38° and 39°C (100°–102°F) is more often present in hepatitis A and E than in
hepatitis B or C, except when hepatitis B is heralded by a serum sickness–like syndrome
 Dark urine and clay-colored stools may be noticed by the patient from 1–5 days before
the onset of clinical jaundice.