A 37-year-old female patient was admitted to the Emergency Department of Tianjin Medical University's General Hospital due to complaints of palpitations and fatigue for 1 week, which worsened over the last 4 days. One week before admission, the patient started having palpitations and fatigue, and occasionally with urinary frequency, without dysuria, fever, headache, dizziness, cough, abdominal pain, or diarrhea. She underwent a blood routine examination in another hospital, and the result showed an increase in the white blood cell count and the neutrophil percentage, a slight increase in procalcitonin (PCT), and five white blood cells/high power in urine. After 3 days of treatment with cephalosporin, the symptoms of palpitations and fatigue did not improve.
Since the onset of this illness, the patient had low energy levels, average appetite, good sleep, normal bowel movements, normal urination, and insignificant weight loss. There was no history of hypertension, diabetes, or coronary heart disease. The patient denied any history of hepatitis, tuberculosis, other infectious diseases, or any food allergies.
The patient presented at our hospital for further diagnosis and treatment. The white blood cell count and the percentage of neutrophils were high. The illness was still considered to be an infection, and the patient was treated with oral levofloxacin hydrochloride tablets. After administering the tablets for 3 days, the white blood cell count increased from 13.18 x 109/L to 19.0 x 109/L, and there was no change in the symptoms of palpitations or fatigue. The patient was admitted for further treatment.
At the time of admission, the patient's body temperature was 36.2 C, pulse rate was 68 bpm, breathing rate was 17 bpm, and blood pressure was 120/72 mmHg. The patient showed mental anxiety, answered questions correctly, had a soft neck, no resistance, no thyroid enlargement, clear breath sounds in both lungs, no rales, good heart sounds, regular heart rhythms, a soft abdomen, no tenderness, rebound pain, and muscle tension. She had no percussion pain in the liver area, negative Murphy sign, no pain in the kidney area, bowel sounds four times per min, normal muscle strength in the limbs, and no swelling of the lower limbs.