Case 35-1961

Presentation of CaseA forty-year-old Venezuelan housewife entered the hospital because of weakness.One year previously the patient experienced the sudden onset of chills, fever and dysuria. Epigastric pain began to occur about fifteen minutes after eating and was often followed by vomiting, frontal headache and marked weakness. After two weeks of novobiocin therapy and one week of penicillin therapy the chills and fever disappeared, but the other symptoms progressed in severity, and the patient was bedridden during the eight months before admission because of weakness. She also complained of increasing constipation and pain in the left shoulder, left scapula . . .