Clinical Reasoning: The “Great Imitator”

Abstract

A 69-year-old man presented with 1 week's history of sweating, confusion, drowsiness, and vomiting. He complained of “burning fumes” olfactory hallucinations. He had hiccups and his wife had witnessed limb jerking. He had a history of paroxysmal atrial fibrillation, hypertension, hyperlipidemia, and type 2 diabetes mellitus.