Blood tests showed moderate inflammation and
anicteric cholestasis (Table).
Anicteric Leptospirosis: A frequently forgotten disease.
In addition, she was acyanosed,
anicteric, febrile (37.8[degrees]C), not in respiratory distress (20 cycles/min), and not dehydrated.
Malik has documented complication of
anicteric hepatitis, bone marrow suppression, paralytic ileus, myocarditis, psychosis, cholecystitis, osteomyelitis, peritonitis, pneumonia, hemolysis, and syndrome of inappropriate release of antidiuretic hormone (SIADH) in order of frequency.7 A study done by Alshosk and Alahmadi on complication of enteric fever showed that maximum cases were with abdominal complications (12.4%).17
Although the asymptomatic form of hepatitis A is typical for childhood, according to Strashimirov and Cherveniakova [35] in the majority of cases (60-80%) hepatitis A has an
anicteric course.
Hence, early creatine phosphokinase (CPK) testing may provide the clue to the diagnosis of occult muscle disease in children with unexplained
anicteric hypertransaminasemia (3).
She appeared pale and had
anicteric bilateral temporal subconjunctival hemorrhage and a nontender abdomen.
Watten, "Sporadic
anicteric leptospirosis in South Vietnam: a study in 150 patients," Annals of Internal Medicine, vol.
At presentation to our unit, she was acutely ill looking, febrile with a temperature of 38.1 [degrees]C, dehydrated, not pale, and
anicteric. Her respiratory rate was 30/minute with reduced air entry and coarse crepitations in both lower lung fields.
It is most commonly seen in immunocompromised patients, neonates, pregnancy, and its presentation can be similar to acute hepatitis
anicteric transaminitis, fever, leukopenia, and flu-like symptoms.[1] It is also characterized by fulminant hepatic necrosis with serum transaminase levels frequently elevated.
On physical exam, she was a febrile and
anicteric. Vital signs were within normal limits without postural change.