Viral Hepatitis Miscellaneous.
We have EBV, CMV and HSV.
Usually cause hepatitis in
Now, we have dealt with this
group of viruses before.
Actually a lot of places.
if there is a CMV, HSV infection
and your patient
is complaining of :
"Doc, had ice cream yesterday
and while I was eating the ice cream,
I've really had pain in my throat."
Upon Upper Endoscopy, maybe
you'll find ulcerations of vesicles
in esophagus, your patient is
most likely immuno-compromised.
Also, CMV, HSV
liver damage, immuno-compromised.
Patients with mononucleosis
may present with self-limited
increased at ALT.
Okay so with EBV, in the US,
most likely your patient,
in college maybe,
Kissings disease, parties,
sharing of beer,
any of an 18 year old patient in such,
who's stressfully feeling tired.
And that this point, you're thinking about
your EBV infection, mono.
In addition, big time, you worry about
the spleen, right.
Because if there's trauma,
death to your patient,
And liver might be involved as well.
Often times, liver and the spleen
go hand in hand, don't they?
Hepatitis presents in pregnancy
with fever, mental status changes,
and in ALT. Remember now,
all viral hepatitides
will have which Transaminases elevated?
You find a pregnant lady
with an increase in ALT,
you're thinking about
Herpes hepatitis and with this,
what are you worried about?
Vertical transmission to the newborn.
Everything that we're dealing with here
is actually taking place in
clinical practice today.
These are the things and
these are the scenarios
that you want to be familiar with.
And if there's anything that you're
memorizing in micro, with viruses,
make sure you come back
and you understand
who your patient is.
Because that's how the questions
will come to you.
Each one of these will be cases.
The faster you're able to identify
your cases and who they are,
the faster that you will then arrive
at the proper answer in terms of
diagnosis, maybe micro and
maybe, perhaps, your pharmacology.
CMV PCR, EBV IGM, EBV PCR,
what these all mean? Diagnosis.
So make sure that you know
what PCR is being used for.
Polymerase Chain Reaction (PCR).
You're looking for you
replication of your viruses.
That becomes of outmost importance
if your dealing with Viral Hepatitis.
You're trying to, as an objective,
I am telling you
in infectious disease
as a criteria, you want to
the sustained viral replication.