Snapshot A 35-year-old man is brought to the emergency department for abdominal pain and flu-like symptoms for the past 2 days. He reports that he just returned from a 2-month trip throughout South America. He reports fever, fatigue, malaise, and right upper quadrant pain but denies diarrhea, melena, hematochezia, nausea, vomiting, or weight loss. A physical examination demonstrates tender hepatomegaly and mild scleral icterus. Introduction Overview login to view 2 more bullets Associated conditions login to view 3 more bullets Epidemiology Risk factors login to view 4 more bullets ETIOLOGY Pathogenesis login to view 3 more bullets Metabolic disease Steatohepatitis Autoimmune hepatitis Drug-induced (e.g., acetaminophen) Alcohol Parasites (e.g., toxoplasmosis) Viral hepatitides (e.g., HAV, HCV, and HBV) Presentation History login to view 2 more bullets Symptoms login to view 9 more bullets Physical exam login to view 6 more bullets Imaging Ultrasound login to view 5 more bullets Studies Serum labs login to view 11 more bullets Serologic Findings Clinical Implications HBV surface antigen Anti-HBV core antibody Active infection Anti-HBV surface antigen antibody Immunity Anti-HBV core antibody Immunity HBV e-antigen C HCV antibody Exposure Differential Chronic hepatitis login to view 2 more bullets Gallbladder disease login to view 2 more bullets Treatment Lifestyle login to view 9 more bullets Medical login to view 8 more bullets Complications Pancreatitis Aplastic anemia Peripheral neuropathy Myocarditis Prognosis The vast majority of patients with acute hepatitis recover completely without complications Overall, low mortality rate but prognosis may be worse if the patient has other comorbidities or initial presenting symptoms such as ascites, edema, or encephalopathy