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Introduction
Case1:
Vomiting
Case 2:
Cough & fever
Case 3: Bruising
Case 4: Sore
throat
Case 5: Jaundice
Case 6: Flu & fever
Case 7: Diarrhea
Case 8: Black
Robe
Catching the
beast
Thanks to
Quiz
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Actually, there are several things to note in
this case:
- First, the diagnosis was not made by culture.
- It required serological detection of
the virus.
- Ms. JS's follow-up will consist of looking for
antibodies, i.e. serological conversion, to the virus.
- People with chronic Hepatitis B develop an autoimmune problem.
- Sounds counterintuitive since they don't make
antibodies to the virus.
- However, as a result they don't eradicate the
virus.
- Viruses continue a low grade replication
in the infected hepatocytes.
- The chronic expression of viral antigens on
the cell surface leads
to:
- A chronic response by T4 lymphocytes.
- The T4 lymphocytes kill the infected cells.
- In time, there is substantial scarring and
loss of liver tissue.
- An interesting, but accurate, twist to this
case is that:
- Hepatitis B should be considered a sexually
transmitted disease.
- What about Ms. JS's boyfriend? Should we
contact him?
- Not directly, but Hepatitis is a reportable
illness.
- Once reported to the state board of health,
someone will follow up.
- Even though he may be a complete deadbeat,
someone needs to get in touch with him and his contacts to try to limit spread
of this disease.
I'm feeling smart now, keep bringing
it on.
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