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Case Reports
. 2023 Nov 3;15(11):e48224.
doi: 10.7759/cureus.48224. eCollection 2023 Nov.

Under Disguise: A Concealed Case of Acute Hepatitis A Infection

Jordan C Malone  1 , Ernesto Zamora  2 , Joseph M Gosnell  3 , Heather L Stevenson  3 , Akshata Moghe  4
Affiliations
Case Reports

Under Disguise: A Concealed Case of Acute Hepatitis A Infection

Jordan C Malone et al. Cureus. .

Abstract

Acute hepatitis A virus infection is routinely identified through a thorough patient history in conjunction with liver chemistries and viral serologies. The diagnosis has the potential to be delayed when the clinical picture is obscured with another, seemingly more urgent presenting pathology with overlapping features. Here, we describe the case of a young female who presented with acute calculous cholecystitis with concurrent acute hepatitis A virus infection.

Keywords: acute cholecystitis; anchoring bias; hav; hepatology; hyperbilirubinemia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. MRI abdomen
Magnetic resonance imaging of the abdomen with and without contrast, demonstrating a 14.2 mm stone in the gallbladder neck
Figure 2
Figure 2. Hepatic histopathology
Image A: Portal tract and lobule with dilated sinusoids and several foci of severe hepatocanalicular cholestasis (blue triangles) and apoptotic hepatocytes (black asterisk) (H&E stain, 20X magnification); Image B: Portal tract and lobule with numerous ceroid-laden macrophages (green arrows) (PAS-D stain, 10X magnification); Image C: Trichrome stain demonstrating centrivenular fibrosis and lobular edema (trichrome stain, 10X magnification). Histological findings are consistent with a diagnosis of active hepatitis A. H&E: hematoxylin and eosin PAS-D: Periodic acid-Schiff with diastase
Figure 3
Figure 3. Gallbladder histopathology
Photomicrograph of abundant eosinophils infiltrating the gallbladder wall muscular layer (H&E stain, 40X magnification)
See this image and copyright information in PMC

References

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