Hepatitis A/Physical Examination

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Overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Hepatitis A virus infection is commonly associated with fever, jaundice, icteric sclera, abdominal tenderness, and hepatomegaly on physical examination. Other pertinent findings include rash, cervical lymphadenopathy, abdominal distension, ascites, and altered mental status.

Physical Examination

Appearance of the Patient

The appearance of the patient on presentation depends on his/her age. Younger patients tend to be asymptomatic, while symptomatic patients tend to be older. Symptomatic patients may have a range of symptoms that can vary in severity from a mild flu-like illness to fulminant hepatitis. Patients with fulminant hepatitis are usually disoriented and very ill-looking.

Vital Signs

• Fever is often present, with a temperature up to 40°C

Pulse

Rate

• Tachycardia may be present

Blood Pressure

• Hypotension may be present

Respiratory Rate

• Tachypnea may be present

Skin

• Jaundice is often present
• Rash may be present
• Petechiae may be present

Eyes

• Icteric sclera is often present

Neck

• Cervical lymphadenopathy may be present

Abdomen

• Abdominal distention may be present
• Abdominal tenderness is often present
• Hepatomegaly with right upper quadrant tenderness is often present
• Splenomegaly may be present
• Ascites may be present in severe stages of disease

Neurologic

• Altered mental status may be present
• Encephalopathy may be present

Gallery

• 

  The viral disease Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.

References

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