A 65-year-old-Male, diabetic not on any medication, chronic smoker, received in ER with BP & Pulse NR. Attendant gave history of sweating followed by? seizure episode and loss of consciousness for 5 minutes at home 1 hour before coming to emergency. No history of fever or vomiting or loose stool & any insect bite or any similar previous episode. Pt is not on examination, or conscious oriented following commands, not dehydrated, GCS 15 with all limb power 5/5 with pupil 3 mm b/l responding to light with plantar b/l flexor.
Radial pulse not felt though b/l femoral & dorsalis pedis felt. B/l rhonchi in chest.All the blood reports came normal with normal NCCT head& Usg abdomen, Xray suggestive of b/l emphysematous changes with prominent bronchovesicular markings. 2D Echo done was also normal. Differential Diagnosis Please
