Complicated Cases in GI

Anthony Kalloo, MD; Jonathan M. Buscaglia, MD

Chapter 47: Fever And A Baltimore Alleyway (continued)

James Hamilton, MD

A 37-year-old man was admitted to the hospital with 5 days of abdominal pain, headache, and myalgias after being found in a Baltimore alleyway. The pain was steadily increasing in severity, mostly focused in the right upper quadrant, and associated with nausea and anorexia. He vomited some coffee-ground material but denied black, tarry stools or frank hemotochezia. He also complained of cough with rust colored sputum, low grade fevers, and 10 lbs of weight loss over the previous 2 weeks. He had no significant past medical history and took no medicines. He was briefly incarcerated 7 days prior…