A 44 year old male emergency medical technician has been feeling fatigued for months. He just doesn't have the same level of energy he used to have. He remembers that he had experienced an episode of jaundice about 10 years ago, but that resolved and he had been healthy since. A CBC reveals that he is not anemic. Slide 5.1 shows a typical gross appearance of a liver with ongoing hepatitis, with necrosis and lobular collapse seen as areas of hemorrhage and irregular furrows and granularity on the cut surface.
Viral hepatitis is the most likely diagnosis.
Hepatitis A is generally a mild, self-limited illness. Hepatitis B and C can produce more chronic disease. However, an identifiable risk may not be found in all cases. The hepatitis A tests suggest that he has IgG antibodies from a remote, not current infection. The hepatitis B surface antibody is negative, though a positive value should be found in a person who received a hepatitis B vaccination.