Liver Fluke Infection in a Russian Immigrant

A 40yearold Russian immigrant presented with a 2week history of right upper quadrant abdominal pain, pruritus, chills, fever, and jaundice. Her past medical history, family history, social history, and review of systems were unremarkable. Before immigrating to the United States 10 years before this hospitalization, she frequently ate freshwater sushi. Other than a lowgrade fever (temperature, 38ºC [100.8ºF]), the patient's vital signs were normal...