Case 5-1990: Fever Three Weeks after an Operation for Pancreatic Cancer

Presentation of Case A 61-year-old woman was admitted to the hospital because of fever, chilliness, and nausea three weeks after an operation for carcinoma of the pancreas. The patient was well until three months earlier, when she began to have persistent low-back pain that was unrelated to position or activity. X-ray study of the spine, a radionuclide bone scan, and an ultrasonographic examination of the pelvis were negative. A barium-enema examination revealed no abnormality except sigmoid diverticula. Anorexia, nausea, and vomiting developed, and one month before admission she first entered this hospital. Physical examination on entry was negative except for…