Case 40-1993

Presentation of CaseA 61-year-old woman was admitted to the hospital because of fever, jaundice, hepatosplenomegaly, and gallstones.The patient had been in stable health until three weeks earlier, when a mild chronic headache developed. One week before admission she consulted a physician, who discovered mild abnormalities on tests of liver function. Five days before entry anorexia, nausea, fatigue, and a low-grade fever developed. Two days later the patient returned to her physician, who diagnosed jaundice and admitted her to another hospital.Laboratory studies were performed at the other hospital (Table 1). An ultrasonographic examination of the abdomen revealed gallstones, . . .