Case history
Case history #1
A 60-year-old man presents with several months of gradually worsening abdominal swelling, intermittent haematemesis, and dark stool. He denies chest pain or difficulty breathing. Past medical and family history are not contributory. Past surgical history is significant for back surgery requiring blood transfusion in 1990. Social history is significant for occasional alcohol use. Blood pressure is 110/80 mmHg. Physical examination is significant for spider angiomata on the upper chest, gynaecomastia, caput medusae, and a fluid wave of the abdomen. The rest of the examination is normal.
Case history #2
A 62-year-old man presents for a routine initial visit in New York. He has occasional arthralgia or myalgia, and takes an ACE inhibitor and a thiazide diuretic for hypertension. A retired accountant and non-smoker, he drinks 1 or 2 beers per week and denies current drug use. Physical examination is normal except for being overweight. Routine blood chemistries are normal, but a screening hepatitis C virus antibody test is positive. At follow-up, the patient is concerned about whether he will develop liver problems. He had heard on television that new oral medications are easier to take than older regimens that used injections and asks about the next diagnostic and treatment steps.
Other presentations
In about one third of those infected, initial exposure to hepatitis C viral infection gives rise to an acute illness.[5] The incubation period before the onset of clinical symptoms in these people ranges from 15 to 150 days.[6] People with an acute infection may present with symptoms of fatigue, arthralgia, or jaundice. However, the majority of infections are asymptomatic.
Use of this content is subject to our disclaimer