17th July 2020

A 45-year-old lady presents to the emergency department with a two-day history of fever

A 45-year-old lady presents to the emergency department with a two-day history of fever accompanied by episodes of feeling cold and shivering. She has not travelled anywhere recently nor eaten anything out of the ordinary, but she reports abdominal pain in the right upper quadrant. Her husband remarks that she is looking yellow today compared to usual. On examination in the emergency department, she has a blood pressure of 89/57mmHg, heart rate of 110bpm and a respiratory rate of 25bpm. Her capillary refill is greater than 5 seconds and she appears to be confused. 

Which of the following options is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.