A 27-year-old man presented to the emergency department with abdominal pain in the left upper quadrant and a pulsatile, painful lesion on the right hand. He reported a 6-week history of fevers, decreased appetite, night sweats, and a weight loss of 12 kg. Physical examination was notable for a temperature of 38.5 degrees Celsius and a grade 3/6 diastolic murmur throughout the precordium. Laboratory studies revealed a WBC count of 18,000/mm 3 . CT angiography of the right arm revealed an aneurysm of the ulnar artery.
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