Presentation of Case A 26-year-old man was admitted to the hospital because of obstructive jaundice. There was a history of inflammatory bowel disease that began at the age of 14 years and was treated successfully on an outpatient basis with prednisone. Two mild flare-ups occurred in subsequent years and were managed well with sulfasalazine. Flexible-sigmoidoscope examination one year before entry was reported to show only a few aphthous ulcers. The patient was well otherwise until three or four weeks before admission, when he experienced nausea, vomiting, chills, and a rise in the temperature to a maximum of 38.3°C, with prompt.
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