The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 50-year-old man presents to the emergency department with a 2-day history of fever and persistent left upper quadrant pain that resulted from a minor blow. Three days before presentation, the patient was playing in his weekly soccer game when he was kicked in his left upper quadrant. Initially, he only felt some soreness in the affected region of his abdomen; however, the pain persisted. The following day, it intensified and was accompanied by a recorded fever of 102°F (38.9°C).
An episode of worsened pain occurred while the patient was trying to relax and watch a football game on the television. He cannot cite any alleviating or aggravating factors and has not noted any changes in his bowel movements. The patient does not report any nausea, vomiting, melena, or hematochezia. His medical history is significant only for gastroesophageal reflux disease (GERD), for which he takes esomeprazole. The patient has not taken any medication for the abdominal pain.
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Cite this: Anusuya Mokashi, Dhana Rekha Selvaraj, Chandrasekar Palaniswamy, et. al. A Soccer Player With Sudden Severe Abdominal Pain and Fever - Medscape - Dec 07, 2020.