Case 42-1989

Presentation of CaseA 64-year-old woman was admitted to the hospital because of Clostridium perfringens sepsis, a gallbladder mass, dysproteinemia, and progressive neuropathy.She was well until three months earlier, when she entered another hospital because of a severe, acute headache. The erythrocyte sedimentation rate was 135 mm per hour. The headache subsided after one day. Microscopical examination of bilateral temporal-artery-biopsy specimens was reported to be negative, but prednisone was administered for a presumptive diagnosis of giant-cell arteritis. The patient experienced lumbar pain, and a radionuclide bone scan was reported to show a questionable increase in activity at the upper . . .