Hepatitis B presenting with tenosynovitis

A 31-year-old nurse's aide developed fever, malaise, migratory arthralgias, arthritis, and severe tenosynovitis six weeks after pricking her finger with a needle contaminated by blood from a patient having type B viral hepatitis. Although disseminated Neisseria gonorrhoeae infection was the initial diagnosis, her symptoms worsened on treatment with ampicillin. While the patient was on aspirin therapy, her symptoms improved dramatically and eventually resolved as she showed evidence, through laboratory findings, of an anicteric hepatitis B infection. Evidently tenosynovitis can be part of the hepatitis B prodrome.