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Hepatitis B presenting with tenosynovitis.

R N Greenberg, W H Eversmeyer, C V Sanders

    Southern Medical Journal
    |March 1, 1979
    PubMed
    Summary
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    Tenosynovitis, a joint inflammation, can be an early symptom of Hepatitis B infection. This case study highlights a nurse

    Area of Science:

    • Hepatology
    • Rheumatology
    • Infectious Diseases

    Background:

    • Hepatitis B virus (HBV) infection is a significant global health concern.
    • Prodromal symptoms of Hepatitis B are typically non-specific and can include fever and malaise.
    • Musculoskeletal manifestations are less commonly recognized as early signs of HBV infection.

    Observation:

    • A 31-year-old healthcare worker developed fever, malaise, migratory arthralgias, arthritis, and severe tenosynovitis.
    • Symptoms began six weeks after a needlestick injury with blood from a patient with type B viral hepatitis.
    • Initial diagnosis of disseminated Neisseria gonorrhoeae was considered, but symptoms worsened with ampicillin treatment.

    Findings:

    • The patient's symptoms significantly improved with aspirin therapy.

    Related Experiment Videos

  • Laboratory findings confirmed an anicteric (without jaundice) Hepatitis B infection.
  • The resolution of tenosynovitis correlated with the diagnosis of Hepatitis B.

    • Implications:

    • This case suggests that tenosynovitis can be a presenting symptom of the Hepatitis B prodrome.
    • Recognizing musculoskeletal symptoms may aid in earlier diagnosis of Hepatitis B.
    • Highlights the importance of considering viral hepatitis in patients with unexplained tenosynovitis, especially after potential exposure.