Diferencia entre revisiones de «Hepatitis A»
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==Background== | ==Background== | ||
*Transmission by | *Transmission by | ||
**Fecal-oral route | **Fecal-oral route | ||
**Most commonly transmitted from asymptomatic children to adults | **Most commonly transmitted from asymptomatic children to adults | ||
**Can also occur with improper food handling, oyster consumption | **Can also occur with improper food handling, oyster consumption | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:Jaundice eye.jpg|thumb|Jaundice from Hepatitis A.]] | |||
*Incubation period 15-50 days | *Incubation period 15-50 days | ||
*Prodrome of [[nausea/vomiting]], malaise | *Prodrome of [[Special:MyLanguage/nausea/vomiting|nausea/vomiting]], malaise | ||
**~1 week into illness, may have dark urine (bilirubinuria), clay-colored stools, [[jaundice]] | **~1 week into illness, may have dark urine (bilirubinuria), clay-colored stools, [[Special:MyLanguage/jaundice|jaundice]] | ||
*No chronic component | *No chronic component | ||
*~1-2% of HAV infections in adults lead to fulminant [[hepatic failure]] | *Can cause aversion to tobacco among smokers | ||
*Death from [[hepatic failure]] is rare | *~1-2% of HAV infections in adults lead to fulminant [[Special:MyLanguage/hepatic failure|hepatic failure]] | ||
*Death from [[Special:MyLanguage/hepatic failure|hepatic failure]] is rare | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Acute hepatitis causes}} | {{Acute hepatitis causes}} | ||
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==Evaluation== | ==Evaluation== | ||
[[File:Hepatitis A serology.jpg|thumb|Hepatitis A serology.]] | |||
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{{Acute hepatitis panel}} | {{Acute hepatitis panel}} | ||
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==Management== | ==Management== | ||
*Supportive care | *Supportive care | ||
**[[Antiemetics]] | **[[Special:MyLanguage/Antiemetics|Antiemetics]] | ||
**[[oral rehydration therapy|Oral]] or [[IVF|IV hydration]] | **[[Special:MyLanguage/oral rehydration therapy|Oral]] or [[Special:MyLanguage/IVF|IV hydration]] | ||
**Avoid hepatotoxic medications | **Avoid hepatotoxic medications | ||
*Patients with fulminant hepatic failure (1-2% of HAV infections) may be considered for liver transplant | *Patients with fulminant hepatic failure (1-2% of HAV infections) may be considered for liver transplant | ||
*Postexposure prophylaxis recommend for non-immunized close contacts of patient | *Postexposure prophylaxis recommend for non-immunized close contacts of patient | ||
==Disposition== | ==Disposition== | ||
*Typically discharge, admit if: | *Typically discharge, admit if: | ||
**INR >2 | **INR >2 | ||
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**Intractable pain | **Intractable pain | ||
**Bilirubin >30 | **Bilirubin >30 | ||
**[[Hypoglycemia]] | **[[Special:MyLanguage/Hypoglycemia|Hypoglycemia]] | ||
**Significant comorbidity/immunocompromised | **Significant comorbidity/immunocompromised | ||
==See Also== | ==See Also== | ||
*[[Acute hepatitis]] | |||
*[[Special:MyLanguage/Acute hepatitis|Acute hepatitis]] | |||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:GI]] | [[Category:GI]] | ||
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Revisión actual - 22:59 4 ene 2026
Background
- Transmission by
- Fecal-oral route
- Most commonly transmitted from asymptomatic children to adults
- Can also occur with improper food handling, oyster consumption
Clinical Features
- Incubation period 15-50 days
- Prodrome of nausea/vomiting, malaise
- ~1 week into illness, may have dark urine (bilirubinuria), clay-colored stools, jaundice
- No chronic component
- Can cause aversion to tobacco among smokers
- ~1-2% of HAV infections in adults lead to fulminant hepatic failure
- Death from hepatic failure is rare
Differential Diagnosis
Causes of acute hepatitis
- Acetaminophen toxicity (most common cause of acute liver failure in the US[1])
- Viral hepatitis
- Toxoplasmosis
- Acute alcoholic hepatitis
- Toxins
- Ischemic hepatitis
- Autoimmune hepatitis
- Wilson's disease
Evaluation
Interpreting Acute Hepatitis Panel Results
| Anti-hepatitis A, IgM | Hepatitis B surface antigen | Anti-hepatitis B core, IgM | Anti-hepatitis C | Interpretation |
|---|---|---|---|---|
| Positive | Negative | Negative | Negative | Acute hepatitis A |
| Negative | Positive | Positive | Negative | Acute hepatitis B |
| Negative | Positive | Negative | Negative | Chronic hepatitis B infection |
| Negative | Negative | Positive | Negative | Acute hepatitis B; quantity of hepatitis B surface antigen is too low to detect |
| Negative | Negative | Negative | Positive | Acute or chronic hepatitis C; additional tests are required to make the determination |
Management
- Supportive care
- Antiemetics
- Oral or IV hydration
- Avoid hepatotoxic medications
- Patients with fulminant hepatic failure (1-2% of HAV infections) may be considered for liver transplant
- Postexposure prophylaxis recommend for non-immunized close contacts of patient
Disposition
- Typically discharge, admit if:
- INR >2
- Unable to tolerate PO
- Intractable pain
- Bilirubin >30
- Hypoglycemia
- Significant comorbidity/immunocompromised
See Also
External Links
References
- ↑ Ostapowicz G, Fontana RJ, Schiodt FV, et al. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med. 2002 Dec 17; 137(12): 947-54.