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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 40-1986. A 28-year-old Cambodian immigrant woman with recent fever and abdominal distention.

Presentation of Case A 28-year-old woman was admitted to the hospital because of fever and ascites. The patient was apparently well until two weeks earlier, when she had a fever and sore throat. A physician prescribed erythromycin, which was discontinued by the patient after two days. Eight days before admission she was seen at another facility because of fever, nausea, vomiting, and abdominal swelling. On examination the temperature was 38.9°C. General physical examination was negative. The abdomen was soft and tympanitic, and no evidence of ascites was found. Pelvic examination revealed no discharge or tenderness on digital movement of the . . .