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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Spinal Cord | 4A0 Case 4 History
Case 4 History ---- The patient was a 55 year old female with a 13 year history of slowly debilitating multiple sclerosis, leaving her severely handicapped but with a preserved intellect. Her fundi were pale with decreased vision bilaterally. There was a right central facial paresis, right medial rectus palsy, spastic quadriplegia with contractures at both elbows and a neurogenic bladder. She was admitted terminally with an infection of a large sacral decubitus ulcer. She became hypotensive, developed tachycardia with metabolic acidosis and hypokalemia and was thought to be in gram negative septic shock. Although she was treated with multiple antibiotics, she developed DIC and a GI bleed, treated with transfusion, with subsequent hepatic and renal failure. She died five days after developing gram negative septicemia.
