Symptoms of viral jaundice

Jaundice is closely related to liver diseases. This type of jaundice is different from neonatal jaundice. Neonatal jaundice is a process that must be experienced after birth and it is also a normal metabolic process. However, many adults experience jaundice, which mostly comes from liver diseases. It is mainly related to the patient's hepatobiliary stones, drug-induced hepatitis and viral jaundice. The cause must be found before treatment.

When suffering from icteric viral hepatitis, it should be differentiated from the following diseases:

(1) Infectious mononucleosis: These patients have fever, pharyngitis, superficial lymphadenopathy, increased peripheral blood leukocytosis and atypical lymphocytes (>10%). The diagnosis can be confirmed by a positive serum heterophile agglutination test and a positive Epstein-Barr virus antibody and immunoglobulin M.

(2) Leptospirosis: This disease must be excluded first in endemic areas. There is a history of contact with infected water, high fever accompanied by obvious pain in the gastrocnemius muscle, superficial lymphadenopathy, bleeding tendency in the skin and mucous membranes, kidney damage, leukocytosis, and positive red blood cells, protein, and casts in the urine. If the pathogen is found in the blood and urine, and the serum Leptospira agglutination and lysis test is positive, it can be differentiated from hepatitis.

(3) Drug-induced hepatitis: A history of taking medications such as chlorpromazine, indomethacin, phenobarbital, sulfonamides, para-aminosalicylic acid, carbarsone, etc. may cause toxic hepatitis. At this time, gastrointestinal symptoms are not obvious, there is no fever before jaundice appears, serum alanine aminotransferase is obviously elevated, but the flocculation reaction is normal, etc., which can be used for identification.

(4) Bile duct stones: more common in middle-aged women, often with a history of recurrent acute abdominal colic that radiates to the shoulders and back. Jaundice is associated with intermittent attacks of abdominal pain. Alkaline phosphatase, cholesterol, γ-glutamyl transpeptidase, etc. are elevated, and stones may be visible on cholangiography.

(5) Pancreatic and gallbladder tumors: more common in the elderly. Pancreatic head cancer has a slow onset, while common bile duct cancer develops insidiously. Patients become noticeably emaciated, pain in the upper and middle abdominal areas continues to worsen, and jaundice progressively worsens. Alkaline phosphatase, cholesterol and 7-glutamyl transpeptidase increased. Ultrasound, CT and MRI examinations can detect tumors, enlarged gallbladder or dilated bile duct, which can confirm the diagnosis.

(6) Others: Care should be taken to differentiate between this disease and liver abscess, relapsing fever, sepsis, etc.