The diagnosis of acute hepatitis can be missed under a number of circumstances.

Barriers to detection of acute hepatitis:

(1) dark colored or covered skin

(2) dark colored or tinted glasses

(3) alternative explanation or concurrent illness

(4) asymptomatic

(5) living alone or social isolation

(6) lighting (poor or altered spectrum)

(7) failure to seek medical care

(8) failure to perform laboratory testing

(9) failure to examine

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