Residents' Clinics
73-Year-Old Man With Hepatomegaly and Weight Loss
A 73-year-old man went to his local hospital because of a 13.6-kg weight loss during a 4-month period, early satiety, and increased abdominal distention. He also complained of weakness and fatigue. He denied having fever, chills, nausea, vomiting, or diarrhea. The patient denied tobacco or ethanol abuse. He had been born in the former Czechoslovakia and immigrated to the United States 20 years previously. He had not been outside the United States for the prior 5 years.27-Year-Old Woman With Fever, Increased Bilirubin Level, and Thrombocytopenia
A 27-year-old woman came to our emergency department because of a 2-day history of severe headache, retro-orbital pain, fever, chills, rigors, nausea, and vomiting. A native of Montana, in the United States, she had been working in Togo, Africa, for the past 3 years. Four weeks before the onset of symptoms, she had traveled to Burkina Faso, in western Africa, and had stayed in an urban area. Since her return to the continental United States 4 days earlier, she had resided in the area of Amelia Island, Georgia.
