An electrocardiogram revealed sinus tachycardia with diffuse, nonspecific ST- and T-wave abnormalities. Laboratory tests were performed ( Table 1 and Table 2). The initial blood pressure was 240/130 mm Hg. He was taken to a second hospital, where another seizure was controlled with phenytoin sodium and a benzodiazepine. One week later, shaking occurred in the patient's left leg and spread to his left arm he lost consciousness and had a witnessed generalized tonic–clonic seizure. Supportive care included parenteral nutrition.
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The results of tests for hepatitis B virus and hepatitis C virus were reported to be positive. Five weeks before admission, he was admitted to another hospital, where hypertension was diagnosed. He noted erythematous lumps over the shins and ankles the lumps waxed and waned for a month before healing.
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Three months before admission, tingling developed in the left toes and progressed to numbness in the foot these symptoms were accompanied by recurrent vomiting, night sweats, intermittent diarrhea, abdominal pain, subjective fever, and a weight loss of 16 kg. One year before admission, he discontinued his use of illicit drugs and began to feel vaguely unwell. The patient had an 18-year history of intravenous drug abuse, including abuse of heroin and cocaine with needle sharing. The most trusted, influential source of new medical knowledge and clinical best practices in the world.Ī 36-year-old, right-handed man was admitted to the hospital because of seizures and severe hypertension.
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