According to Right Diagnosis, viral hepatitis, Budd-Chiari syndrome, liver flukes, liver abscesses and typhoid fever are common causes of tender hepatomegaly. Other possible causes include hemangiomas, hydatid cysts, paratyphoid fever, intra-abdominal sepsis and abscesses. Some less common causes can be leukemia, Bearn-Kunkel syndrome, Katayama fever, Weil's disease, Dubin-Johnson syndrome, infectious mononucleosis, pylephlebitis and very long-chain acyl-CoA dehydrogenase deficiency.
Hepatitis occurs when the liver becomes enlarged and tender as a result of a viral infection. Other causes of hepatitis include an overactive immune system, drug use, alcoholism, chemical exposure and environmental toxins.
In addition to tender hepatomegaly, symptoms of a hepatitis infection include fever, muscle and joint pain, jaundice, fatigue, weight loss, abdominal pain and diarrhea. Hepatitis can also cause nausea, vomiting, loss of appetite, dark urine, mild anemia, body itching and colorless stools.
Viral hepatitis occurs most commonly in three forms, including type A, B and C, according to the University of Maryland Medical Center. Hepatitis D and E are also possible, but these types are rare. Hepatitis A can spread through contact with feces, close contact with someone who has the virus or by ingesting contaminated food or water. Hepatitis B and C are spread through contact with infected blood, usually when people share contaminated needles. Hepatitis B can also be contracted through unprotected sex, notes the University of Maryland Medical Center.