The patient is a 62 year old Indian male with a past medical history significant for myasthenia gravis, hypertension, and diabetes mellitus, who presented to an outside hospital with fever, fecal incontinence, and melena. Work up at that hospital was remarkable for elevated liver function tests, heme-positive brown stool and a CT of the abdomen showing a thick ascending colon suggesting possible mass. The patient had an episode of desaturation and fever to 105 degrees Fahrenheit prior to transfer to Thomas Jefferson University Hospital for further evaluation. Upon arrival, the patient was in respiratory distress with oxygen saturation of 70% on 5 liters of oxygen by nasal cannula. He was immediately intubated.
Patel, Monica and Wilhelm, Jennifer
"Melena with Fever,"
The Medicine Forum:
Vol. 3, Article 7.
Available at: http://jdc.jefferson.edu/tmf/vol3/iss1/7