ABSTRACT
A 67-year-old Caucasian man has presented to the emergency department complaining of flu-like symptoms and generalized weakness. He was well until six months ago, but since then he has had three episodes of pneumonia. Over the past week he developed dizziness, cough, diarrhoea, vomiting and progressive weakness. He was unable to get up from his bed on the day of presentation. His medical history includes ischaemic heart disease. He is an active smoker with 40 pack years history, but there is no history of alcohol or substance misuse. He has not travelled abroad in the last 10 years. He takes certain drugs: aspirin, 75 mg once daily; atenolol, 50 mg once daily; isosorbide mononitrate MR, 30 mg once daily.
