Gary is a 21 year old Caucasian college student that was taken by a friend to the campus clinic. The friend states, ”I’m really concerned about Gary. He was doing great in school, but got a little too involved in partying and not eating right. Lately he has just been going to the salad bar at the corner deli. He hasn’t been feeling well for a couple of days.You may want to check his eyes; they look kind of yellow to me.” The campus clinic PA is able to evaluate Gary who reports general fatigue, muscle aches, loss of appetite, and nausea/vomiting with abdominal pain. He also reports that his stools have been clay-colored and his urine dark brown. Physical exam is remarkable for low-grade fever (99.9), yellow sclerae and skin, and mild right-sided abdominal tenderness without evidence of enlarged liver or spleen. Gary appears disheveled and tired. He states, ”I’m just really tired. Can I get some pills to help me sleep and feel better?” The PA suspects Hepatitis A.
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