A 26-Year-Old Woman With Pleural Effusion, Hydronephrosis, and Ascites

Kaleem Ullah Toori, MB BS; Sumaira Nabi, MB BS; Sadaf Khattak, MB BS; Herbert S Diamond, MD


August 16, 2018

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to recognize accurately. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.


A 26-year-old Pakistani woman presents to the emergency department with a 1-week history of nausea, vomiting, diarrhea, lower abdominal pain, and dysuria. She was previously treated for pulmonary tuberculosis about 2 years ago.

She has 3 children, all of who were normal vaginal deliveries and were born healthy. She has a 1-year history of menstrual irregularity and dysmenorrhea. She is a nonsmoker and is not taking any medications on a regular basis. Her family history is unremarkable.


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