July 2020 critical care case of the month: not the pearl you were looking for

Abstract

No abstract available. Article truncated after 150 words. History of Present Illness A 75-year-old man presented with unsteady gait, difficulty concentrating and abdominal pain with loose stools. One day prior to admission, he experienced waxing and waning nausea, cramping abdominal pain, one episode of emesis and loose stools. He described acute gait disorder related to difficulty with balance. Due to concern for dehydration, he drank 10-12 cans of carbonated water without further emesis. He also experienced vague and alternating sensations of feeling “hot” in half of his body and “cold” in the other half of his body. Forty-eight hours prior to presentation, he had just returned from a five-day trip to New Orleans. PMH, SH, and FH: The patient has hypertension and hyperlipidemia that is well-controlled. Regular medicines include losartan, diltiazem, HCTZ and simvastatin. He is a professor of medicine. He had distant tobacco use with a 10 pk-yr history. He denies recreational drug use. He endorsed drinking …

Keywords

• neurotoxic shellfish poisoning
• oysters
• red tide
• treatment
• diagnosis
• bradycardia
• brevetoxin
• mortality
• temperature reversal
• gastrointestinal
• shellfish poisoning