A 56-year-old man. He was fine util one month before admission when he suddenly presented weakness, complaining of right upper quadrant abdominal pain, chills, fever, and jaundice. On admission, the temperature was 35.1°C, the pulse was 42, and the respirations were 12. The blood pressure was 50/20 mmHg. He had a white cell count of 23.5 × 109/L with 92% neutrophils. His haematocrit was 36.4%, with a mean corpuscular volume of 86.9 μm3 and a platelet count of 122/mm3, and abnormal liver-function test: protein 4.9 g/dL, albumin 1.7 g/dL, total bilirubin 11.5 mg/dL, conjugated 7.5 mg/dL, Alkaline phosphatase 1,408 U/L, Aspartate aminotransferase 246 U/L, Alanine aminotransferase 339 U/L. The patient died and the emergency room, and the pathological diagnostic was performed.
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