On further questioning...

...the patient reported no unusual food ingestion. No other person in her combat unit has become ill. She denied recreational drug use including alcohol. The patient is sexually active with a steady boyfriend. She had been using oral contraceptive pills over the past 6 months. Her last menstrual period was 10 days ago and was described as normal. Family history was non-contributory.

On physical examination, she was jaundiced but afebrile. She was alert and oriented. Asterixis was absent. The liver was mildly tender on deep palpation and palpable 2 finger-breadths below the costal margin. Liver edge was smooth. There was no shifting dullness on percussion. Spleen was not palpable.