A 60 yo man with severe abd pain in epigastrium + right hypochondrium, fever x 1 wk + fatigue + headache; chronic nonbloody loose diarrhea for past year, worse with high-fat diet. He reports no vomiting, weight loss, or cachexia. Read on for complete case:
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.
The patient does not drink alcohol or smoke; however, he consumes three to four cups of coffee per day. He suggests that his diarrhea may be caffeine-related, although he has not noticed changes when he varies his coffee intake. Colonic diverticulosis was detected incidentally 5 years ago through routine colonoscopy, when he was age 55 years . Because the diverticulosis was asymptomatic, no treatment was recommended.
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