Patient, a 95 yrs old,otherwise healthy male presented with generalised itching with fine maculopappular,reddish rash over neck and forearms about 2 months back. Rash used to appear and disappear on its own.There was no h/o fever,cough or urinary symptoms.
Investigations revealed raised liver enzymes( SGOT and SGPT about 10 times the normal range and ALP was only marginally raised).Serum bilirubin was normal and so was complete haemogram.Urine showed presence of sugar and numerous pus cells.Blood sugar was high and so was HbA1c(FBS 190mg/dl, PPS 280mg/dl, HbA1c7.5%).Urine culture showed growth of Ecoli sensitive to Azithromycin and Levofloxacin.Patient has a history of recurrent UTI and was diagnosed with a solitary GB calculus,an incidental finding during routine ultrasound done about a year back.However he never complained of pain in epigastrium or any other symptom related to gall…
