Approach to splenic masses Quiz: Ace Your Exams
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A 42-year-old woman presents to the emergency department with two days of fever and abdominal discomfort. The patient describes the pain as a dull ache beneath the left rib cage. The pain has been constant, without any specific exacerbating or alleviating factors. The patient recently returned from a two-week vacation on a sheep farm in South America. There is no significant past medical history, and the patient takes no medications. The patient does not use alcohol, tobacco, or drugs. Temperature is 38.4ºC (101.1ºF), pulse is 96/min, respiratory rate is 16/min, blood pressure is 147/82 mmHg, and oxygen saturation is 98% on room air. On physical examination, the patient appears fatigued but otherwise in no acute distress. Cardiopulmonary auscultation is unremarkable. There is fullness and tenderness to palpation over the left upper quadrant. Scattered petechiae are present over the forearms and legs. No lymphadenopathy is noted. An abdominal ultrasound is ordered. Which of the following is the most likely diagnosis?
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