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Author: Haseeb Raza / Editor: Sarah Edwards / Codes: GP1, GP7, SLO1, SLO2 / Published: 30/08/2024

A 34-year-old male presents to the Emergency Department (ED) with a three-day history of headaches, fever, rigors, nausea, and vomiting. He also reports abdominal pain, predominantly in the right upper quadrant (RUQ). He recently returned from Sudan.

Examination showed:

  • Respiratory Rate -18/min
  • Oxygen Saturations – 95% on Air
  • Pulse – 101 beats per min
  • Blood pressure – 125/73mmHg
  • Temperature of 38.7 degrees Celsius.
  • Clear chest with bilateral normal air entry.
  • Normal Heart Sounds, well perfused, no pedal oedema.
  • Tenderness in RUQ, with guarding on deep palpation.

The relative blood results are as follows:

  • Haemoglobin (Hb): 107
  • White blood cell count (WCC): 18 uL
  • C-reactive protein (CRP): 264 mg/L
  • Alkaline phosphatase (ALP): 100 IU/L
  • Alanine transaminase (ALT): 103 IU/L
  • Bilirubin: 25 umol/L
  • Lipase: 58 U/L

Renal function (U&Es) is within normal range.

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