Patient may have only some of the following symptoms; the abdominal exam may be unrevealing:

• Chills and fever (90%)
• RUQ or epigastric tenderness (70%), with or without cessation of inspiration on palpation (Murphy sign); atypical locations can occur
• Jaundice (60%)
• Hypotension (30%)
• CNS depression (10–20%)
• Palpable nontender gallbladder (Courvoisier sign) rarely
• Signs of underlying pathology, such as chronic liver disease