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A 23 year old Caucasian male, with no significant past medial history, was admitted to University Hospital for evaluation of fever, chills and back pain. The patient reported that, five days prior to admission, he developed intermittent fever and chills with no specific pattern. He started taking ibuprofen and OTC medications for influenza with only partial relief. Two days prior to admission, he noticed back pain and, on the following day, he developed discomfort in his RUQ. He also reported fatigue and headaches. Nine months prior to his presentation, the patient took a trip to India (Mumbai, Chennai) and Sri Lanka; he was traveling for three weeks and visited markets, beaches and an elephant sanctuary.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License.