A 26-year-old woman in her third trimester presents with fever, malaise, and deepening jaundice over 5 days. She recently returned from a rural area where she drank untreated well water. AST is 1450 U/L, ALT 1620 U/L, prothrombin time markedly prolonged. Which virus is most likely responsible?

• A Hepatitis E virus ✓
• B Hepatitis B virus
• C Hepatitis C virus
• D Hepatitis A virus

Explanation

Hepatitis E is enterically transmitted via contaminated water and causes a self-limited illness in most adults, but carries a mortality approaching 20 percent when acquired in the third trimester, usually from fulminant hepatic failure. Hepatitis D can cause severe disease in pregnancy but not with this degree of excess maternal mortality. Hepatitis B and C are bloodborne and their acute icteric phase does not follow faecally contaminated water exposure.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.