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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 345:201-205 July 19, 2001 Number 3
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Case 22-2001— A 25-Year-Old Woman with Fever and Abnormal Liver Function
Eric J. Rubin, M.D., Ph.D., and Fiona M. Graeme-Cook, M.B.B.C.

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Presentation of Case

A 25-year-old woman was admitted to the hospital because of persistent fever.

The patient was a resident of the Philippines who had flown to the United States 11 days before admission and spent 6 days in California. Seven days before admission, she had a temperature of 38.2°C, with a mild headache and a nonproductive cough. Amoxicillin provided by her mother did not reduce the patient's temperature. Three days before admission, her temperature rose to 40°C, and she began to take acetaminophen and ibuprofen, without relief of the fever. One day before admission, she came to this hospital; at this time, . . . [Full Text of this Article]

Differential Diagnosis

Bacteremia Due to Colonic Flora

Coinfection with Strongyloides stercoralis

Gonococcal Infection

Bacterial Endocarditis

Infection with Vibrio Species

Melioidosis

Typhoidal Tularemia and Typhoidal Plague

Typhoid Fever

            General Aspects

            Clinical Findings

            Pathogenesis

            Treatment

Conclusions

Clinical Diagnoses

Dr. Eric J. Rubin's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References




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