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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.
A 20-year-old man presented to the emergency department after a syncopal episode. During the previous 2 weeks, he had had persistent low-grade fever, anorexia, rhinorrhea, and headache. On the morning of admission, he felt weak and then collapsed while walking into a room; he had no other antecedent symptoms. His mother, who witnessed the fall, did not notice any seizure-like activity. Once
Commentary
Source Information
From the Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA (N.J.L., R.M.W.); the University of California, San Francisco, School of Medicine and the San Francisco Veterans Affairs Medical Center, San Francisco (G.D.); and the Ann Arbor Veterans Affairs Health Services Research and Development Center of Excellence and the University of Michigan Health System, Ann Arbor (S.S.).
Address reprint requests to Dr. Leeper at the Falk Cardiovascular Research Center, 300 Pasteur Dr., Stanford, CA 94305, or at nleeper@cvmed.stanford.edu.
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