Hepatitis is responsible for significant morbidity and mortality in the pediatric population. It is fundamental that pediatricians understand the broad differential diagnosis of pediatric hepatitis and develop the ability to recognize the different signs and symptoms of disease, as well as initiate the primary evaluation.

After completing this article, readers should be able to:

  1. Describe the broad differential diagnosis of pediatric hepatitis.

  2. Recount the initial evaluation for suspected hepatitis.

  3. Identify the signs and symptoms of acute and chronic hepatitis.

  4. Describe the evaluation and initial management of acute liver failure.

  5. Determine when to refer or consult.

A previously healthy, fully vaccinated, 11-year-old girl presents with fever and sore throat for 3 days. She has a maximum temperature of 101.5°F (38.6°C) and notes throat pain with swallowing. The family denies any sick contacts, but the patient attended a birthday party 10 days before presentation. She denies any cough, congestion, vomiting, diarrhea, or...

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