![]() ![]() The jugular venous pressure was measured at the sternal angle. On presentation, the patient was afebrile (temperature 36.5☌), with a blood pressure of 127/82 mm Hg, a pulse of 72 beats/min, a respiratory rate of 18 breaths/min and an oxygen saturation of 97% in room air. He had no history of renal disease or drug allergies. He reported having taken ibuprofen (400 mg) for myalgia no more than 3 times over the 2-week period before presentation. The patient had a history of coronary artery disease and was taking acetylsalicylic acid (81 mg daily) and atorvastatin (40 mg daily). He had started taking oral pantoprazole (40 mg daily) 6 weeks earlier. ![]() He had a history of gastresophageal reflux that did not respond to ranitidine. The case: A 57-year-old man presented to hospital with a 2-week history of progressive malaise, myalgia, fever, nausea, vomiting, diarrhea, polyuria and polydipsia. ![]()
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