A 44-Year-Old Man Who Had a Mysterious Accident

Timothy C. Petersen, MD; Romesh K. Khardori, MD, PhD

Disclosures

February 14, 2019

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.

Background

A 44-year-old white man with a medical history remarkable for hypertension and dyslipidemia presents to a local emergency department with a chief symptom of weakness. He states that he recently recovered from a sore throat that started 1 week ago, but he has since developed fatigue and global weakness.

The patient fell 1 day ago and struck his head; he attributes the fall to his weakness. He denies other neurologic changes, including headache, vision changes, sensory changes, focal motor weakness, and dizziness. Fluid and nutrient intake are noted to be normal. He states that he is adherent with his usual home regimen of lisinopril and simvastatin. He smokes 10 cigarettes per day but denies illicit drug use and ethanol intake.

A review of systems is negative for fever, appetite changes, chest pain, palpitations, diarrhea, and nausea.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....