Case 10-1993: A 67-Year-Old Man with Mitral Regurgitation and an Abrupt Onset of Ataxia and Fever

Presentation of Case A 67-year-old man was admitted to the hospital because of ataxia and the recent onset of atrial fibrillation. The patient had been well until one month earlier, when he began to experience sweats without documented fever. During the two weeks before entry he lost 3.6 kg in weight. One day before admission he staggered on getting out of bed and was taken to a hospital, where his temperature was 37.4 °C; the heart rhythm was regular; his gait was ataxic, with a broad base and a parkinsonian shuffle; and he repeatedly fell to his left side. Two . . .