Journal 11, November 2022pages: 775-776
1 Internal Medicine C, Meir Medical Center, Kfar Saba, Israel
2 Gastroenterology and Liver Diseases, Meir Medical Center, Kfar Saba, Israel
3 Radiology, Meir Medical Center, Kfar Saba, Israel
4 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
A 70-year-old male arrived at the emergency department (ED) with symptoms of fever, shivering, and sweating for 3 days. A dry cough started a week before admission. There were no other referring symptoms. The patient, a farmer by occupation, denied any animal bite or exposure, travel abroad, consumption of uncooked meat, or drink of unpasteurized milk products. In the ED, his vital signs showed hypotension with blood pressure of 70/40 mmHg, pyrexia of 39.4°C, and tachycardia of 100 beats per minute. On physical examination, the patient shivered. On auscultation, fast heart sounds were heard.