ABSTRACT
A 23-year-old chemistry student was admitted to hospital complaining of headache, nausea and shortness of breath. She was a reluctant historian, but the junior doctor taking the history managed to elicit that she had experienced fevers and nausea for around 48 hours and now had worsening shortness of breath on minimal exertion. The patient was well known to have a long history of depression with multiple emergency department attendances following episodes of deliberate self-harm. These had included mixed overdoses of drugs, such as sertraline, paracetamol and zopiclone, as well as self-inflicted wrist and forearm lacerations. On direct questioning, she admitted that she had ‘done something a while ago’ but refused to clarify this further. She had no further past medical history and was currently on no regular medications. She lived alone and had no current sexual partners. She denied any history of smoking or alcohol intake.
