Note - this is unusual.

Initial work-up

For children aged 3 months and above:

• Hepatitis A/B serology
• CMV, EBV, LFT, FBE
• Serum bilirubin

NB: All are optional. May be most beneficial for rural patients pre-referral.

Recommended pre-referral treatment

Well child:

• Get a drug history ie. paracetamol use.

Unwell child:

• Consider fulimant liver failure.

When to refer

Well child:

• Call the Gastroenterologist on call for advice.

Unwell child:

• Enlarged tender liver,fever, lethargy, dehydration - IMMEDIATE REFERRAL to the Emergency Department on 03 9345 6592

Resources

• Make a referral:Specialist Clinics
• Contacts
• RCH Primary Care Liaison (GP website)
• Kids Health Info (Parent information website)  

References and more reading

• Prolonged Jaundice

Guideline developed by the RCH Departments of Dermatology and Allergy and Immunology in consultation with a GP Review Group. Many thanks to the GPs involved in the review.  First published Nov 2007. Reviewed August 2009.
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