A 20-year-old female college student comes to your clinic with a 1-week history of malaise, anorexia, nausea, and vomiting. Three weeks ago, she returned from Thailand, where she had engaged in a volunteer work in a village.
On physical examination, temperature is 38.0C. There is mild jaundice and a palpable, tender liver.
Lab studies: Hct 48%, WBC 9000, ALP 110, ASL 1400, AST 1800, total bilirubin 2.8.
What is the most likely diagnosis?
On physical examination, temperature is 38.0C. There is mild jaundice and a palpable, tender liver.
Lab studies: Hct 48%, WBC 9000, ALP 110, ASL 1400, AST 1800, total bilirubin 2.8.
What is the most likely diagnosis?
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コメント(2)
I think it's accute hpatitis A.
reasons below
first, I think her liver doesn't work well because of "mild jaundice"and"tender liver".
and from ASL and AST, it seems like liver cells is broken suddenly.
second, I think the sewage line in the poor village (in Thailand) isn't developed enoughly, and hepatitis A virus can get into her body with unclear water and foods.
next, sympton of hepatitis A seems like a cold, same to this patient.
and incubation stage of hepatitis A is about a month, so it's almost fit into "Three weeks ago, she returned from Thailand."
I think we have to check her anti-hepatitis A IgM in her blood to make final diagnosis.
reasons below
first, I think her liver doesn't work well because of "mild jaundice"and"tender liver".
and from ASL and AST, it seems like liver cells is broken suddenly.
second, I think the sewage line in the poor village (in Thailand) isn't developed enoughly, and hepatitis A virus can get into her body with unclear water and foods.
next, sympton of hepatitis A seems like a cold, same to this patient.
and incubation stage of hepatitis A is about a month, so it's almost fit into "Three weeks ago, she returned from Thailand."
I think we have to check her anti-hepatitis A IgM in her blood to make final diagnosis.
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