He was acyanosed, anicteric
, afebrile (36.6 [degrees]C), not in respiratory distress (18 cycles/min), and not dehydrated.
ERCP is however warranted now in follow-up to rule out pancreas divisum as a cause of pancreatitis and also to countercheck the patency of CBD despite the patient being anicteric
Physical examination revealed an extremely distended and tense abdomen, severe caput medusae, a readily reducible umbilical hernia, and anicteric
About 90% of those infected develop a mild anicteric
form of the disease.
Most of these patients have had subclinical, anicteric
Clinically, it shows a broad spectrum of clinical manifestations ranging from subclinical infection and self-limited anicteric
febrile illness (80%-90% of all cases) to icteric leptospirosis known as Weil's disease (mortality rate of 5%-10%) (3).
His conjunctivae were mildly pale, and his sclerae were anicteric
. There was no palpable enlarged lymph node.
He showed a moderate clinical presentation: anicteric
form and mild spontaneous hemorrhage (ecchymosis in the right eye).
While all of these were evident in cases 1 and 2, the patient in case 3 had a solitary rise in aminotransferases and mild ARE Additionally, previous reports have noted an anicteric
pattern of hepatitis as a commonality in presentation of this disease, though this was not seen in case 1 or 2 in this series [2, 8].
In this study only 4 patients within 2 months of age were anicteric
EBV hepatitis usually has a cholestatic pattern, so that anicteric
cholestatic hepatitis is observed in approximately 60% of the patients, while jaundice occurs only in 5-7% of all patients [11, 12].