A 47-year-old man with a history of hypertension and diabetes, but no renal disease, presented with depressed mental status. Past medical history It revealed a cough, nausea, diarrhoea, and muscle aches for 5 days before admission. On the day before admission, his speech became tangential and disordered, and uncoordinated movements and stumbling while walking developed. The patient had a history of intravenous drug abuse, but no recent use by the report. In the emergency department, his temperature was 101.6°F, his heart rate was 155 beats per minute, and his blood pressure was 132/78 mm Hg.
His respiratory rate was 21 and his oxygen saturation was 100% on room air. Aggressive fluid resuscitation was initiated. Respiratory distress and worsening oxygen saturation developed and the patient required intubation and mechanical ventilation. Laboratory investigations Initial labs were notable…
