Bacterial Hepatitis
Etiology: Bacterial hepatitis is less common than viral hepatitis and can be caused by various bacteria, including Leptospira, Salmonella, and Brucella.
Pathophysiology: Bacteria can infect the liver directly or indirectly through systemic infections. The infection can lead to inflammation and damage to liver cells.
Clinical Presentation: Symptoms can include fever, jaundice, right upper quadrant pain, and hepatomegaly. In severe cases, it can lead to liver abscesses or sepsis.
Diagnosis: Diagnosis is typically based on clinical presentation, laboratory tests (elevated liver enzymes, bilirubin), and imaging studies. Blood cultures can help identify the causative organism.
Treatment: Treatment involves antibiotics targeting the specific bacteria. Supportive care for liver function may also be necessary.
Key Points for Specific Bacterial Causes
Leptospirosis:
- Transmission: Contact with water contaminated by animal urine.
- Symptoms: Fever, myalgia, jaundice, and conjunctival suffusion.
- Diagnosis: Serology (MAT test), PCR.
- Treatment: Doxycycline or penicillin.
Salmonella:
- Transmission: Ingestion of contaminated food or water.
- Symptoms: Gastroenteritis, fever, hepatosplenomegaly.
- Diagnosis: Blood cultures, stool cultures.
- Treatment: Ciprofloxacin or ceftriaxone.
Brucellosis:
- Transmission: Ingestion of unpasteurized dairy products, contact with infected animals.
- Symptoms: Fever, sweats, hepatomegaly, splenomegaly.
- Diagnosis: Blood cultures, serology.
- Treatment: Doxycycline and rifampin.
Mnemonics
Leptospirosis: “Lepto Leaps from Water” (Leptospira from water contamination).
Salmonella: “Salmon Swim in Food” (Salmonella from contaminated food).
Brucellosis: “Bruce Drinks Milk” (Brucella from unpasteurized dairy).
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This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services. Please refer to your doctor for medical advice.