A Man With Right-Sided Weakness.

Abstract

A-57-year-old deaf-mute male with type 2 diabetes and a history of HIV infection receiving Odefsey treatment presented to the ED with right-sided weakness, headache, poor appetite, and loss of spirit for 2 weeks. On arrival, his temperature was 38°C, the pulse was irregular at 148 beats per minute, and the blood pressure was 123/88 mmHg. Physical examination showed right-sided weakness. The muscle strength of both right upper and lower limbs was grade 3. Electrocardiogram showed atrial fibrillation with rapid ventricular response. The laboratory tests showed elevation of C-reactive protein (6.35 mg/dL), but white blood cell count (8,600/uL), procalcitonin (0.19 ng/mL), renal and liver functions tests, and urinalysis were all within normal range. The chest X-ray revealed cardiomegaly and mild pulmonary congestion. Brain computed tomography (CT) for a suspected stroke was arranged (Fig. 1).