首页|Acute confusion in a 55-year-old man with endstage renal disease
Acute confusion in a 55-year-old man with endstage renal disease
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NSTL
Cma-Canadian Medical Assoc
A 55-year-old man with end-stage renal disease secondary to diabetes presented to hospital with a 1-day history of confusion and word-finding difficulties. His medical history included diabetic nephropathy, anemia secondary to renal disease, gout, dyslipidemia, hypertension (baseline blood pressure 150/90 mm Hg) and depression. His regular medications were perindopril, amlodipine, lanthanum carbonate, allopurinol, linagliptin, rosuva-statin, citalopram, insulin and erythropoietin. He had been receiving continuous cycling peritoneal dialysis for 7 months, with no recent changes. Three weeks earlier, the patient had developed an erythematous and clustered, painless rash on his back and scalp, which was not in a dermatomal distribution. Three days before his hospital visit, his family physician had prescribed oral valacyclovir 1g three times daily for presumed zoster infection. He had taken 4 doses of valacyclo-vir by the time he presented to hospital.
NSTL
Cma-Canadian Medical Assoc
