小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 发热
- 不适感
- 恶心和呕吐
- 黄疸
- 肝肿大
- 右上腹痛
- 陶土色大便
其他诊断因素
- 疲劳
- 头痛
- 小便黄赤
- 瘙痒
- 关节痛和肌痛
- 咳嗽
- 腹泻
- 便秘
- 脾肿大
- 颈后淋巴结肿大
- 短暂皮疹
- 心动过缓
危险因素
- 生活在地方性流行地区
- 与感染者密切接触
- 男男性行为者
- 发达国家人群到甲肝流行地区旅游
- 注射吸毒者
- 已知食源性疾病暴发
- 接触托儿所儿童或工作人员
诊断性检查
首要检查
- 血清氨基转移酶
- 血清胆红素
- 血尿素
- 血清肌酐
- 凝血酶原时间
- 抗HAV-IgM抗体
需考虑的检查
- 抗HAV-IgG抗体
- 电镜检测粪便及体液
- 甲肝病毒RNA(HAV RNA)检测
治疗流程
无疫苗接种史，且近期有甲型肝炎病毒暴露史者（＜2周）
确诊的甲型肝炎
撰稿人
作者
Musaddiq Waheed, MD
Hospitalist Physician
Archbold Memorial Hospital
Thomasville
GA
Assistant Clinical Professor
Florida State University School of Medicine
Tallahassee
FL
利益声明
MW declares that he has no competing interests.
鸣谢
Dr Muaddiq Waheed would like to gratefully acknowledge the late Dr Fida A. Khan for his contribution to this topic.
利益声明
FAK declared that he has no competing interests.
同行评议者
Howard J. Worman, MD
Professor of Medicine and Cell Biology
Columbia University College of Physicians and Surgeons
New York
NY
利益声明
HJW declares that he has no competing interests.
Srikrishna Nagri, MD
Gastroenterologist
Dartmouth-Hitchcock Nashua
Nashua
NH
利益声明
SN declares that he has no competing interests.
George Y. Wu, MD, PhD
Professor of Medicine
University of Connecticut Health Center
Farmington
CT
利益声明
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
利益声明
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
利益声明
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.
鉴别诊断
- 急性乙型肝炎
- 戊型肝炎
- 急性丙型肝炎
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