A 52-year-old woman was admitted to the hospital with right upper quadrant pain, fever, and chills. Three weeks earlier, the patient started having waxing and waning fevers, with temperatures up to 102癋, associated with chills and profuse diaphoresis. The abdominal pain was described as dull, constant, localized to the right upper quadrant, and radiating to her back. She denied any precipitating or associated symptoms. She did report general malaise and weight loss of 13 lb in 2 months. There was no nausea, vomiting, diarrhea, or pruritus. The patient is originally from India and has been living in the United States for the last 20 years. She had visited India approximately 3 months before this presentation.
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