Dr. Kent Kreisman, Junior Assistant Resident in Medicine, Jewish Hospital of St. Louis, and Assistant in Medicine, Washington University School of Medicine: A 44-year-old white woman was hospitalized on March 10, 1968, with a five-day history of fever, chills, and malaise. The past history included meningitis in childhood, recurrent asthma for 17 years, and a complete hysterectomy four years prior to admission.
Physical examination revealed a middle-aged woman appearing acutely ill. Pulse rate was 120 beats per minute and regular; blood pressure, 110/60 mm Hg; respiratory rate, 20 per minute; and temperature, 104 F (40 C). Findings from examination of the head, ears, eyes, nose, throat, and thorax were unremarkable. No lymph-node enlargement was detected. The liver was palpable 6 cm below the costal margin; the spleen was not felt. Findings from examination of the extremities and the nervous system were normal.
Laboratory data on admission included a hematocrit reading