Can you make the diagnosis?

Lisa has been feeling under the weather for the last few days. She has felt very tired, and has not been hungry at all. She has been feeling nauseated and having diarrhea.

When she wakes up on Monday, she notices that her urine is dark brown. She looks into the mirror, the whites of her eyes look yellow!

What does Lisa have?


  1. Influenza
  2. A urinary tract infection
  3. Gallstones
  4. Hepatitis A



If you guessed 4. Hepatitis A, you are right!

There is currently an outbreak of Hepatitis A in the United States.  The outbreak has been linked to homeless communities and drug use, and then is spread to other individuals in the community.  There currently have been 15,000 cases of Hepatitis A since the outbreak started, and 140 deaths.

Hepatitis A is a virus that is transmitted from person to person.  Transmission of the virus can be caused by contaminated food or water.

The Hepatitis A virus results in inflammation of the liver.  It causes symptoms such as fatigue, decreased appetite, stomach pain, nausea, vomiting, diarrhea, dark urine and jaundice (yellowing of the skin).

The symptoms usually resolve within two months of infection.  Children may have different symptoms then adults.

Hepatitis A can be prevented with a vaccination.  The vaccination is given as a series.  Other important preventive measures include good hand washing, and properly cooking food.  If an individual is traveling to an area where Hepatitis A is common, they should consider getting a vaccination prior to their trip.

If an individual thinks they have been exposed to Hepatitis A, they should contact their health care provider or the State Health department.  If a patient has been exposed, they may benefit from an injection of either Hepatitis A vaccine or immune globulin but this must be done within the first two weeks after exposure.

Influenza usually is accompanied by fever, body aches, and can have vomiting and diarrhea, but jaundice or icterus (yellowing of the skin or eyes) would be unusual.  Urinary tract infection would usually cause fever, pain with urination, and can cause vomiting, but would not typically cause jaundice or icterus.  Gallstones would typically cause severe abdominal pain and vomiting, but unless other significant liver problems would be unusual to cause icterus.


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