Case presentation: A 31-year-old woman presented with fever, pain in the abdomen, and hepatitis. She informed that she had recently been sexually active with a new male partner and had no significant medical history. Physical examination: The patient was febrile (38·2°C), tachypnoeic (respiratory rate 44 breaths per/min), tachycardic (heart rate 120 beats/min).
The abdomen was tender in the right upper quadrant. Signs of jaundice were absent. Laboratory investigations Alanine aminotransferase:629 units/L (normal <35) Aspartate aminotransferase: 634 units/L (normal <30) Gamma-glutamyl transferase: 182 units/L (normal <38) Alkaline phosphatase: 143 units/mL (normal <110) C-reactive protein concentration: 192 mg/L (normal <3) Total bilirubin concentration within normal limits Radiological findings: Ultrasound of the abdomen revealed pericholecystic fluid and biliary sludge in the gall…
