Case Presentation A 54-year-old previously healthy man presented with a one-week history of upper abdominal pain accompanied by nausea, vomiting, nonbloody diarrhea, dizziness, fatigue, intermittent fever, anorexia, and an unintentional 10-kg weight loss. Symptoms began shortly after recent travel to Tunisia, with no significant past medical or surgical history.
Physical Examination on Admission Vital signs: Within normal limits; afebrile initially Abdominal examination: Mild epigastric and right upper quadrant tenderness Cardiovascular examination (later during admission): Mild to moderate diastolic murmur at the left lower sternal border Systolic murmur at the apex radiating to the left axilla Initial Laboratory Investigations Mild anemia (hemoglobin 11.2 g/dL) Elevated inflammatory markers: C-reactive protein: 83.8 mg/L Erythrocyte sedimentation rate: 39 mm/hr Mildly elevated…
