The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. 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 60-year-old woman presents with nausea, vomiting, diarrhea, abdominal pain, and chest pain. She reports eating wings at a local restaurant 3 days prior, after which she developed nausea and subsequently had multiple episodes of nonbloody, nonbilious emesis and diarrhea. She reports that the emesis and diarrhea improved after 2 days; however, the substernal chest pain and epigastric abdominal pain, with radiation to her back, worsened, prompting her to seek medical attention. She denies any fevers, chills, sick contacts, diaphoresis, dizziness, shortness of breath, or palpitations.
She has a known past medical history of systemic lupus erythematosus (SLE); breast cancer, which was treated with lumpectomy, chemotherapy, and radiation and is now in remission; hypertension; diabetes mellitus; asthma; and osteoarthritis. About 2 months prior, her dose of prednisone was increased to 60 mg daily due to a lower-extremity rash thought to be secondary to lupus (Figure 1).
Despite multiple medical comorbidities, she is still independently performing activities of daily living and doing well, without any recent hospitalizations.
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Cite this: A Woman With Back, Chest Pain After Eating Wings at a Restaurant - Medscape - May 31, 2022.