Case Presentation

A 41 year old Southeast Asian woman presented to the Emergency Department (ED) complaining of acute onset of nausea and abdominal pain as well as a two weeks of palpitations and two months of cough productive of white sputum. The patient also complained of fever, shortness of breath and dyspnea on exertion over the previous week. Patient history revealed a past medical history of asthma. The patient had no prior surgical or psychiatric history, had no known drug allergies, and consumed no chronic medications. The patient reported that she had immigrated to the United States from Laos in 1986. She denied any tobacco, alcohol or illicit substance abuse.