Question of the Week

Question :

Posted On : 21 Nov 2006

How to differenciate between infective hepatitis and malarial and enteric induced hepatitis?

Expert Answer :

No expert answer available.

Answer Discussion :

pediatriconcall

In viral hepatitis, fever subsides with appearance of jaundice whereas in malaria and enteric fever, fever is present along with jaundice. By doing serological test and identifying the positive test. For malaria, one can demonstrate either parasites by peripheral smear or do dipstick tests.

18 years ago

anil shukla

By first establishing the definitive diagnosis. Also, jaundice in cases of Malaria is often due to heamolysis when ALT levels may not be very high. But then the question specifies hepatitis, so obviously ALT is raised in the present case.

18 years ago

DR SONI S ADURKAR

smear for malarial parasites, positive widal, hepatitis antigen and antibody screen will be of help

18 years ago

pramod m.kulkarni

clinically-
1}fever subsides with appearance of jaundice-viral hep.
2}degree of jaundice,enzyme levels usually modest in nonviral hepatitis
3}serology-HAV-HEVIgM,HbsAg

18 years ago

puru

you expect pallor in malaria ,no pallor in other two situations .
prescence of spleen more in case of enteric fever and malaria ,not in viral hepatitis { both these arguements are not absolute , i agree. because malaria can present as pure hepatitis form without hemolysis and small speen in viral hepatitis is common.
the time of jaundice may help in viral hepatitis jaundice follows the prodrome of fever ,but in malaria and enteric jaundice is a little bit late in onset.
spleen if firm is more in favour of malaria.
most important the incidence of malaria presenting in hepatitis form is far less than common viral hepatitis. and enteric fever presenting with hepatitis are much sick
of course investigatins like total and differential count , retic count and peripheral smear help.
another interesting lab result is widal may be positive in malaria. which further confuses the picture

18 years ago

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