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Altered Mental Status, Thrombocytopenia and Leukopenia in a Hiker 

Altered Mental Status, Thrombocytopenia and Leukopenia in a Hiker
Chapter:
Altered Mental Status, Thrombocytopenia and Leukopenia in a Hiker
Author(s):

Daniel Caplivski

and W. Michael Scheld

DOI:
10.1093/med/9780199735006.003.0066
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date: 27 May 2019

Case 13e: A 71-year-old woman presented to the emergency room in early July with weakness and fatigue. She reported that the fatigue had begun two days prior, and had been associated with nausea, vomiting, and diarrhea. She had also experienced several episodes of shaking chills and near syncope, and had been unable to get out of bed for the 24 hours prior to admission. The patient's medical history included diabetes, hypertension, and hyperlipidemia managed with nateglinide, valsartan, and simvastatin. In the emergency department, she noted increased thirst and abdominal pain, but denied fevers, rash, myalgias, arthralgias, headache, or dysuria. Her daughter reported that she had been slightly confused in the 24 hours before admission. She was an avid hiker and member of a hiking club; her last hike had been almost 2 weeks prior on Bear Mountain in upstate New York. She was originally from China, and 3 months before her presentation she had been hiking in the mountains of Peru.

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