The patient was healthy until 4 weeks prior (mid-July 2012) to her transfer, when she developed sudden-onset abdominal pain, right flank pain, and anorexia (Figure 1). Evaluation at a local emergency department, including an abdominal ultrasound, was reportedly normal. The impression was possible renal colic and constipation. She was discharged with acetaminophen and stool softener. Approximately 3 weeks later, she presented to a local clinic with progressive general and lower extremity weakness, left-eye blurry vision, cough, chest congestion, and palpitations. She was diagnosed with viral syndrome and given eye drops. Three days later, her symptoms worsened. She developed dyspnea and bilateral blurry vision. She was rushed to the emergency department, where she was hypertensive (blood pressure [BP] 180-200/130 mm Hg), tachycardic (150 beats/minute), and diaphoretic.
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机译：该患者直到转移前4周（2012年7月中旬）都健康，当时她出现了突然发作的腹痛，右胁腹疼痛和厌食症（图1）。据报道，包括腹部超声在内的当地急诊部门的评估正常。印象可能是肾绞痛和便秘。她用对乙酰氨基酚和粪便软化剂出院。大约3周后，她就诊于当地诊所，患有进行性全身和下肢无力，左眼视力模糊，咳嗽，胸部充血和心。她被诊断出患有病毒综合征并接受了眼药水治疗。三天后，她的症状恶化。她出现呼吸困难和双眼视力模糊。她被送往急诊室，那里有高血压（血压[BP] 180-200 / 130 mm Hg），心动过速（150次/分钟）和发汗的感觉。
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