Clinical Presentation
ACUTE HEPATITIS
Signs and Symptoms
The majority of acute viral hepatitis
infections are asymptomatic, or they can cause an anicteric illness that may
mimic other viral infections. Hepatitis C may also be asymptomatic.
Hepatitis C_Initial AssesmentPre-icteric Phase
Non-specific systemic symptoms (eg myalgia, nausea, vomiting, fatigue, malaise with discomfort in the right upper quadrant of the abdomen), altered sense of smell or taste, coryza, photophobia, headache, cough, diarrhea, dark urine and serum sickness-like syndrome are noted. Hepatomegaly, splenomegaly and lymphadenopathy may be seen on physical examination.
Icteric Phase
Jaundice is usually observed when fever drops or completely resolves.
Fulminant Hepatitis
The development of symptoms of hepatic encephalopathy (eg confusion, drowsiness) is seen within 8 weeks of symptoms or within 2 weeks of the onset of jaundice. There may be hypoglycemia and prolonged prothrombin time (PT).
Routes of Transmission
The routes of transmission for hepatitis C are blood transfusions, organ transplants, percutaneous (especially intravenous [IV] drug use), sexual, and perinatal.
Incubation Period
The incubation period of hepatitis C is 14 to 180 days.
History
The important points in the clinical history of patients with suspected viral hepatitis are contacts with jaundiced patients, IV drug use, history of blood transfusion, surgery or hospitalizations, family history of chronic liver disease, occupation, food and water sources, past or current medication use, alcohol use, unexplained chronic liver disease and/or chronic hepatitis, long-term hemodialysis, HIV infection, and a history of multiple sexual partners and/or sexually transmitted infections (STIs).