Case Report

A 67 year-old male with a past medical history of hypertensionand insulin-dependent type II diabetes complicated byneuropathy, retinopathy, and chronic kidney disease presentedto the hospital with a complaint of fatigue. The patient notedgeneralized weakness that had begun the morning of admissionafter two days of malaise and subjective fever. This weaknessprevented him from being able to rise from a sitting position,resulting in a fall off the couch. He denied injury from this fallalong with shortness of breath or chest pain, however, he didadmit to two episodes of vomiting the day prior to admission.

The patient was taking the following medications: furosemide,aspirin, isosorbide mononitrate, lipitor, levothyroxine,candesartan, metoprolol, clopidogrel, doxazosin, calcitrioland Insulin 70/30. Medical history included, hyperlipidemia,hypothyroidism, benign prostatic hypertrophy, stable angina,and peripheral vascular disease along with the conditionslisted above. Past surgical history included 2 stents in the LADcoronary artery, vitrectomy, and transurethral resection of theprostate (TURP). Additionally, the patient noted that he livedalone after having retired from teaching and denied any drugs,smoking or alcohol.