Causes of jaundice

Jaundice develops in many infectious diseases, primarily in icteric forms of acute viral hepatitis A, B, C and E, acute viral hepatitis of mixed etiology (mainly viral hepatitis B and viral hepatitis D, other combinations are extremely rare), as well as in superinfection with hepatitis viruses in patients with chronic hepatitis.

Infectious diseases accompanied by jaundice syndrome

Name of the disease or pathogen	Differential diagnostic criteria
Acute VHA-VGE	Epidemiological history, cyclicity of the course, presence of symptoms of the pre-icteric period, markers of the acute phase of viral hepatitis, high ALT activity
Epstein-Barr virus	The icteric form of hepatitis develops in 5-10% of cases of infectious mononucleosis. hepatosplenic syndrome, symptoms of EBV infection. ALT activity is slightly increased
Yellow fever, other HF	Epidemiological history, jaundice with fever and hemorrhagic syndrome
Other viruses	Very rarely, hepatitis is caused by ECHO, Coxsackie, HSV, rubella, measles, chickenpox, parvovirus B19 (viral hepatitis unspecified) or GBV-C, SEN, TTV viruses.
Mycoses	Granulomatous infiltration of the liver and spleen is possible, with histoplasmosis, blastomycosis, aspergillosis, cryptococcosis, coccidioidomycosis - without pronounced clinical symptoms, after recovery, calcifications remain
UMV infection	In newborns - hepatomegaly, jaundice, congenital developmental defects; in adults - mononucleosis-like disease with signs of hepatitis, can develop after blood transfusions; in HIV-infected people it develops in the late stages of the disease

Bacteriosis

Tuberculosis	Granulomatous hepatitis, jaundice develops rarely, alkaline phosphatase activity is significantly increased
Salmonellosis	Jaundice develops rarely, with a generalized course - liver abscess
Liver abscesses	Can develop with many bacterial diseases (especially gram-negative), abscesses in other organs, fever, the presence of focal lesions in the liver during ultrasound: changes in the general blood test, positive blood culture
Listeriosis	A disease of sapronotic and zoonotic nature, occurring as a septic process with damage to many organs, including the liver. Acute hepatic encephalopathy may develop. To confirm the diagnosis, it is necessary to obtain a blood culture, sowing of cerebrospinal fluid, amniotic fluid, etc.
Yersiniosis (generalized form)	Against the background of other symptoms of Yersinia infection (polyarthritis, exanthema, fever), hepatitis sometimes develops. The course is benign

Spirochetosis

Leptospirosis	Epidemiological history, severe jaundice with fever, simultaneous kidney damage, hemorrhagic syndrome
Syphilis	In newborns, the liver and spleen are enlarged; in adults, hepatitis with jaundice in the secondary period or gummas in the tertiary period.
Relapsing fever	Epidemiological history, intoxication syndrome, hepatomegaly, jaundice develops rarely

Protozoosis

Malaria	Epidemiological history, hepatosplenomegaly, suprahepatic jaundice, typical temperature curve, anemia
Leishmaniasis	In visceral leishmaniasis, the liver and spleen are enlarged, there is fever, anemia and thrombocytopenia, and the parasite is detected in blood smears or bone marrow aspirates.
Amebiasis	Extraintestinal manifestation of amebiasis - amoebic liver abscess (usually single, with liquid white contents), which occurs with symptoms of intoxication without obvious signs of colitis. The liver is enlarged, but the functions are slightly impaired
Toxoplasmosis	Usually asymptomatic chronic infection of internal organs without dysfunction: in children infected transplacentally - damage to the central nervous system and other organs, jaundice, congenital malformations; with reactivation of the disease in HIV-infected individuals - meningoencephalitis

Helminthiasis

Echinococcosis	One or more large encapsulated blisters; asymptomatic course, liver functions are preserved for a long time: diagnosis is clarified by ultrasound. detection of antibodies in the blood
Alveococcosis
Fascioliasis	In acute fascioliasis - fever, enlargement and tenderness of the liver, eosinophilia; in chronic - cholangitis, biliary fibrosis; detection of immature eggs in feces or bile samples
Clonorchiasis	Cholangitis, cholelithiasis, cholangiocarcinoma
Toxocariasis	Hepatomegaly, granulomas, eosinophilia
Schistosomiasis	Gradual enlargement of the liver and spleen, fibrosis, portal hypertension syndrome

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