Symptoms of hepatitis A in children

For the pathology, there is a consistent succession of 4 periods: incubation,jaundiced, post-jelly. But since often hepatitis A proceeds in an anzhelic form, the physicians distinguish several other periods of the disease:

• incubation;
• prodromal( precocious);
• the period of heat;
• convalescence.

Symptoms of hepatitis A in children are quite diverse and depend on the current stage of the disease.

Symptoms of the incubation and pre-zheltushnogo period

The duration of the incubation period is 10-45 days. Sometimes it can be reduced to 8 days and increased to 50 calendar days. For the period is characterized by a complete absence of any clinical symptomatology.

The duration of the prodromal - pre-jaundiced - period is 3-7 days. Conditionally it is divided into the infectious and the stage of secondary toxicosis, each of which is accompanied by its clinical picture.

Infectious stage

Signs of hepatitis A in the infectious stage are characterized by the development of symptoms of intoxication of the body. For the disease, a typically acute onset:

• increased body temperature to significant levels;
• worsening of general well-being and development of strong weakness;
• headache;
• increased heart rate - tachycardia;
• attacks of nausea, resulting in vomiting;
• abdominal pain.

The stage of secondary toxicosis

It is during this period of the disease that one can talk about the development of the first signs of hepatitis A. The emerging clinical picture indicates liver failure. Symptoms appear gradually against the background of normal body temperature:

• the child becomes sluggish, drowsy, apathetic;
• complains of dizziness;
• worsened appetite;
• is aversed by fatty foods;
• there are eructations, attacks of nausea, resulting in vomiting.

At the stage of secondary toxicosis, the symptoms of liver damage are especially pronounced. It becomes bigger, denser. The child begins to complain about a feeling of discomfort, the place of localization of which becomes the right hypochondrium. Do not be ruled out the appearance of pain.

When you try to palpate the body, pain occurs. In childhood, the increase in the liver occurs due to changes in the volume of its right lobe. In the study of blood there is a rapid increase in the activity of liver enzymes and the acceleration of the reaction of van den Berg. At the end of the prodromal period, the darkening of the excreted urine and the decolorization of stool are indicated.

After the development of jaundice, the child's condition improves somewhat

Symptoms of icteric period

The icteric period is conventionally flowing in 3 stages: buildup, acceleration and recession. With the development of jaundice, the child's condition is most often stabilized. At the beginning of icteric period - in addition to changes in the appearance of faeces and urine - the yellowing of the eyes, mucous membranes of the mouth becomes yellowing. Then the shade of the skin of the face and trunk changes. Legs and arms turn yellow in the last turn.

Depending on the intensity of staining, jaundice can be mild and moderately severe. In some cases, jaundice is growing at a rapid pace - the child becomes completely yellow within a day. After reaching the peak of maximum manifestation of jaundice, after 2-3 days, begins to decrease. Completely it passes only after 7-10 days.

Sometimes the condition persists for several weeks. It is worth noting that the itch of the skin for hepatitis A is atypical. But sometimes it develops at the peak of the condition in adolescents. In addition to the increase in bilirubin levels in the blood, which provokes the development of jaundice, the patient has changes during protein, fat, carbohydrate and other metabolic processes.

At the very beginning of the icteric period, body temperature remains within the physiological norm. But in the future, its sharp jumps can be noted, due to the presence of concomitant pathologies. In particular, deviations in the work of the myocardium are revealed in practically all patients.

Other organs involved in the process of digestion are involved in the pathological process. For example, an increase in the spleen is recorded in about 20% of all diagnosed cases of viral hepatitis A. A modification of the organ at the peak of jaundice development is determined. Then the state is normalized.

Signs of the after-jaundice period and the convalescence period

The main indicator indicating the end of the icteric period is the normalization of blood indices. There is a restoration of the physiological level of bilirubin.

The average duration of icteric period is two weeks, but sometimes it lasts for a month or more.

The total duration of the after-zoster phase is variable and can be as long as two to three weeks, and several calendar months. At the same time, there is no clear line between its end and the beginning of the period of convalescence. Clinical criteria in this case are the restoration of normal liver size, a decrease in the activity of liver enzymes.

The length of the recovery phase can take several months, during which the child must periodically take tests. In most cases, complete recovery occurs, but chronization of the process is not excluded.

Symptoms of hepatitis A in infants

The course of hepatitis A in children of the first year of life has some characteristics. In most cases, a mixed viral-bacterial infection is diagnosed, which is detected during a monthly survey. Most often, viral hepatitis is combined with staphylococcal infection.

After hospitalization of the child it is often found out that the revealed hepatitis A is not the primary form, but the aggravation of the pathology proceeding in a latent state. It is explained by intrauterine infection.

Viral hepatitis A in infants is very difficult. For him, a typical shortening of the pre-jaundiced period is typical. As a rule, it lasts no more than 5 days and many clinical symptoms remain unnoticed. And the disease itself begins with the development of jaundice.

Symptoms of the prodromal period in infants can be:

• a violation of appetite - the baby eats little and with great reluctance;
• frequent plentiful regurgitation;
• lethargy, drowsiness;
• stool disorder due to a number of infections or staphylococci.

But most often the disease begins with a rise in body temperature to 39 ° C and above. Catarrhal phenomena can be noted, which prevents the correct diagnosis. The only reliable sign of the development of hepatitis A in a nursing baby is a change in the color of urine - it darkens - and complete discoloration of stool.

Symptomatic of hepatitis depending on the severity of

The severity of the disease is usually determined during the peak of the icteric period. Evaluation criteria are current clinical symptoms and changes in biochemical processes.

The degree of severity of the disease depends on the manifestations of toxicosis, which reflect functional disorders in the liver

With mild viral hepatitis, the symptoms of intoxication are either completely absent or slightly expressed. The child feels quite satisfactory, there is no violation of appetite and sleep. Increased blood bilirubin levels are minimal. There are also minor deviations from accepted norms in other biochemical indicators.

For moderate to moderate course, a moderate manifestation of symptoms of toxicosis is characteristic. These are:

• disturbance of general well-being;
• lethargy, capriciousness;
• refusal of food, accompanied by aversion to fatty foods and foods;
• attacks of nausea, resulting in vomiting;
• drowsiness;
• headaches;
• is painful when trying to palpate the liver.

When listening to the chest, muffled heart sounds are noted. The development of arrhythmia is not ruled out. This indicates the presence of disturbances during metabolic processes. There are more significant deviations from the norm in biochemical indicators. For a severe form of hepatitis A, a rapid development is typical.

The prodromal period is short and is accompanied by signs of severe intoxication, to which symptomatology of hepatic insufficiency joins. On the formation of severe forms of hepatitis A in children, the following symptoms are indicated:

• inhibition, apathy, drowsiness;
• a sharp violation of appetite until a complete refusal to eat;
• repeated vomiting;
• headache, dizziness;
• tenderness in the right hypochondrium;
• shortness of breath;
• muffled heart tones;
• arrhythmia;
• strong yellowing of the skin;
• formation of small-point hemorrhages.

The outcome of hepatitis A in most cases is favorable, regardless of the symptomatology.