Biomedical subjects
Publications and source records attributed to N Timko.
A child with amebic colitis, liver abscess and hepatitis A is reported. Speculation as to why these two infectious agents have rarely been associated is presented. Diagnosis of hepatitis was not suspected in this case until physicians caring for the patient developed clinical hepatitis. The importance of suspecting hepatitis A in all patients with unexplained liver enzyme elevations is stressed.
A nosocomial outbreak of hepatitis A occurred after hospitalization of a 21-month-old girl with amebic liver abscess and unsuspected, anicteric hepatitis A. The index patient, who had an acute diarrheal illness prior to enzyme elevations, seroconverted from IgM hepatitis A antibody to IgG hepatitis A antibody. Of the 103 hospital personnel with known or potential exposure, three physicians (2.9%) contracted clinical hepatitis A, 27 to 29 days after their initial contact with the source patient. A fourth physician developed subclinical infection. Two of the three clinical cases occurred in two of the three primary care physicians of the source patient. Hepatitis A should be considered in any patient with acute, unexplained liver enzyme abnormalities. Diarrhea occurring in a fecally incontinent child incubating hepatitis A may increase the risk of transmission.