More than just a stomach ache

A young woman has a number of symptoms including jaundice, acute abdominal pain and fever.

A  23-year-old woman presented to the ED, with a 10-day history of vomiting, myalgia, and upper abdominal pain. 

Rash

Three days before presentation she had seen her GP who prescribed empirical clarithromycin, with no improvement in her symptoms. Two days later, she developed jaundice and pruritus, prompting her to attend hospital. 

She had a history of ulcerative colitis with a pan-proctocolectomy and end-ileostomy. She took no regular medication, rarely drank alcohol and had no history of travel abroad or recent blood transfusions.

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