Summary
Definition
History and exam
Key diagnostic factors
- fever
- malaise
- nausea and vomiting
- jaundice
- hepatomegaly
- RUQ pain
- clay-colored stools
Other diagnostic factors
- fatigue
- headache
- dark urine
- pruritus
- arthralgias and myalgias
- cough
- diarrhea
- constipation
- splenomegaly
- posterior cervical lymphadenopathy
- evanescent rash
- bradycardia
Risk factors
- living in endemic region
- close personal contact with an infected person
- men who have sex with men
- travel outside the US
- injection drug use
- known foodborne outbreak
- contact with a child or employee in a childcare center
Diagnostic investigations
1st investigations to order
- serum aminotransferases
- serum bilirubin
- BUN
- serum creatinine
- prothrombin time
- IgM anti-hepatitis A virus (HAV)
Investigations to consider
- IgG anti-hepatitis A virus (HAV)
- electron microscopy of stool and body fluids
- Hepatitis A virus RNA detection
Treatment algorithm
Contributors
Authors
Musaddiq Waheed, MD
Hospitalist Physician
Archbold Memorial Hospital
Thomasville
GA
Assistant Clinical Professor
Florida State University School of Medicine
Tallahassee
FL
Disclosures
MW declares that he has no competing interests.
Acknowledgements
Dr Muaddiq Waheed would like to gratefully acknowledge the late Dr Fida A. Khan for his contribution to this topic.
Disclosures
FAK declared that he has no competing interests.
Peer reviewers
Howard J. Worman, MD
Professor of Medicine and Cell Biology
Columbia University College of Physicians and Surgeons
New York
NY
Disclosures
HJW declares that he has no competing interests.
Srikrishna Nagri, MD
Gastroenterologist
Dartmouth-Hitchcock Nashua
Nashua
NH
Disclosures
SN declares that he has no competing interests.
George Y. Wu, MD, PhD
Professor of Medicine
University of Connecticut Health Center
Farmington
CT
Disclosures
GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.
Kittichai Promrat, MD
Assistant Professor
Division of Gastroenterology
Department of Medicine
Brown University
RI
Disclosures
KP declares that he has no competing interests.
Pierre Van Damme, MD, PhD
Professor
Director of Vaccine & Infectious Disease Institute
University of Antwerp
Antwerp
Belgium
Disclosures
PVD has been and still is principal investigator of vaccine trials for several vaccine manufacturing companies, from which the university obtained and obtains research contracts and funds for conducting such vaccine trials.
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