clinical features
Last reviewed 01/2018
Following an incubation of 14 to 26 days, there is a 'flu- like illness, characterised by:
- headache and fever - predominant
- raised temperature - 38 to 41 degrees centigrade
- chills, malaise, anorexia
- respiratory and gastrointestinal symptoms occur late with dry cough, chest pain, crackles after about 5 days
- hepatosplenomegaly is common with biochemical evidence of hepatitis
- entire course rarely exceeds 2 weeks - usually, 3 to 6 days - may resolve spontaneously
- endocarditis may result - especially of the aortic valve
About 20% of cases, often in the elderly, have a protracted form which may last for 4 weeks. A granulomatous hepatitis occurs in one third of these. Significant features are:
- absence of respiratory features and headache
- presence of hepatomegaly and right upper quadrant pain