Unusual Presentation of a Rare Adult Disease in a 15 Year Old with Charcot's Triad

A 15-year-old previously healthy girl presented to the hospital with acute onset fever, epigastric pain, and scleral icterus associated with chills and non-bloody diarrhea. She denied sick contacts, recent travel, or new medications. Family history was significant for a mother with Multiple Sclerosis and a cousin with Crohn's disease (CD). Social history was unremarkable. On arrival, she was febrile to 104 degrees, tachycardic but remained normotensive. On examination, she was nontoxic with obvious scleral icterus. Abdomen was soft, non-distended with RUQ and epigastric tenderness without organomegaly. Murphy's and Rovsing's signs …