Question

A woman from rural area reported to the local hospital with high fever (102^oF), light sensitivity, joint pain, and muscle pain. Her examination showed mild jaundice, and pain in the right upper quadrant of the abdomen. She also had swollen cervical lymph nodes, on both sides of her neck. Her physical revealed temperature of 102.4^oF, pulse of 90 beats/min, respiratory rate of 26/min, and BP of 110/70 mm Hg. Laboratory findings gave erythrocytes a little low, leukocytes normal, platelets low, alkaline phosphatase high, aspartate aminotransferase high, and alanine aminotransferase high. Dermatologic examination showed no rashes, petechiae, or ulcerations. She was not around any rodent manifestations.

What etiologic agent could cause this?

Answer 1

Our women from rural area was admitted to the hospital with a severe right upper quadrant pain and with of fever ( 102F) , She had no notable medical history , She had no , alcoholic use and no recent use of over the counter medication or the dietary supplements , smoking , illiegal drug use or the sexual activity , On physical examination her vital reveals;-

T=102F

RR=26bpm

BP =110/70mmHg
PR =90bpm

Physical examination and vital signs wre unremarkable aside from a temperature of 102F and the right upper quardrant pain , there was no hepatospleomegaly sign or any flank dullness.

Laborartory studies revealed the following ;-

Erythrocytes low

platelets low

alkaline phosphatase high ,

aspartate aminotransferase high

alanine aminotransferse high

total bilirubin and direct bilirubin goes high

Her hemoglobin level , leukocytes count , urinlysis , amylase . lactate , electrolyte , serum creatinine levels were all wiyhin normal limits,

The patient's laborartory studies suggest hepatocellular injury with mild hyperbilirubuinemia , which can be seen with the acutte chongitis which is caused by choledocholithasis . , Acute cholangitis must be considered in every patient with rightupper quadrant pain , fever , and hyperbilirubinemia because it has a mortality rate if the diagnosis is being delayed . the initial test would include liver ultra sonography and blood cultures .

Cholangitis is an inflammation of the bile duct system . The bile duct system carries bile from our liver and gallbladder into the first part of our small intestine ( duodenum) .

In most cases cholangitis is caused by the bacterial infection , and often happens suddenly