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Case
Summary
Review
Viral Hepatitis
1.
Viral hepatitis was seen in two siblings. Jon acquired hepatitis
type A in an endemic area from ingesting food or water containing
contaminated human fecal matter. Laura contracted type B
hepatitis from a navel piercing from unsanitary conditions.
Either the equipment was contaminated or the person(s) involved
in the piercing procedure were carriers of the virus, or possibly
both.
2.
The symptoms of the various forms of hepatitis are very similar.
They include nausea, vomiting, weight loss, jaundice and
tiredness among others.
3.
The diagnosis of the disease was made by two medical doctors
specializing in internal medicine. One had a sub-specialty in
infectious diseases. The elevated liver enzymes indicated
damaged hepatocytes and subsequent diminished liver function.
Both patients showed some jaundice due to a build-up of bilirubin
in the skin. Tests showed the presence of the virus because the
immune system reacted to the virus's presence by forming
antibodies, or by demonstrating viral particles circulating in
the patient's serum. As you recall, the IgM immunoglobulin class
of antibodies appear early in the course of the disease then
gradually decline. On the other hand, IgG antibodies rise
later and are those responsible for lasting immunity.
4.
Treatment consisted of replacing fluids lost through dehydration
from vomiting and diarrhea. Rest and nourishment eventually
restored both patients to a healthy state. In some
patients, the administration of the substance alpha-interferon
may improve the course of the disease, particularly with
hepatitis B and C.
5.
The prognosis for recovery from hepatitis is very good,
especially in otherwise healthy individuals such as Jon and
Laura.
6.
Prevention is based on avoidance of risk factors. Hepatitis B
protection can be acquired through a vaccine. In most states, it
is required for all health care professionals. Additionally,
a vaccine for hepatitis type A is available. Unvaccinated
individuals should exercise caution when in endemic areas by
avoiding possibly contaminated food and drink from unreliable
sources.
7.
Two physicians collaborated in this case to form a diagnosis.
Both had specialties in internal medicine, but one of the
physicians also had a specialty in infectious disease.
Nurses were responsible for treating many of the symptoms
including administering medications and intravenous fluids.
Clinical laboratory scientists were responsible for the liver
function tests as well as the diagnostic hepatitis antigen and
antibody tests.
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