A Mysterious Death

• Published in: The New England journal of medicine Vol. 338; no. 24; pp. 1764 - 1769
• Main Authors: Oldach, David W, Benitez, R. Michael, Borza, Eugene N, Richard, Robert E
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 11-06-1998
• Subjects: Alcoholic Intoxication - history; Alexander the Great (356-323 BC); Arsenic; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Diagnosis, Differential; Famous Persons; Fatalities; Greece, Ancient; Grief; History; History, Ancient; Human bacterial diseases; Humans; Infections; Infectious diseases; Intestinal Perforation - etiology; Intestinal Perforation - history; Male; Medical research; Medical sciences; Typhoid Fever - complications; Typhoid Fever - history; Wine - adverse effects; Wine - history; Wines; Human; Nervous system diseases; Motor system disorder; Perforation; Etiopathogenesis; Gut; Salmonella typhi; Infection; Case study; Association; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Complication; Enteritis; Paralysis; Enterobacteriaceae
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199806113382411

Presentation of Case
A 32-year-old man presented with fever and pain in the right upper quadrant. The patient had been well until the day after a night of heavy alcohol consumption (12 pints of wine
1
,
2
), when fatigue and generalized aches developed. The following evening, he consumed a similar quantity of wine and had sharp pain in the right upper quadrant of such severity that he cried out.
3
The pain resolved quickly, but the area remained tender to palpation. He later had chills, sweats, and fever, which continued into the next day.
The patient bathed in cool water and . . .