CASE 51
A 49-year-old woman presented with high fever and chills, jaundice, and upper abdominal pain for 3 days.
LABORATORY STUDIES
Imaging
A CT scan of the liver demonstrated a large multiloculated cyst with bile duct dilation (Fig. 51-1).
Diagnostic Work-Up
Table 51-1 lists the likely causes of the woman’s illness (differential diagnosis). A clinical diagnosis of hepatic hydatid cyst (tapeworm) disease was considered based on the imaging studies (CT scans of liver). Serologic tests specific for a tapeworm may include
TABLE 51-1 Differential Diagnosis and Rationale for Inclusion (consideration)
Rationale: Clinical diagnosis is difficult; the history of exposure is helpful. The symptoms are suggestive of biliary tract infection, which may have many causes. Viral hepatitis would not produce lesions seen in the CT scan. The more common causes are listed above. Hydatid cyst is a possibility when appropriate epidemiology is present.
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