Case 31-2002

Presentation of Case A 61-year-old man was admitted to the hospital because of right hemiplegia, aphasia, and obtundation. According to the patient's family, he had been well at his home in Haiti until about one month earlier, when pain developed in his right leg. Two days later, an ultrasonographic examination of the leg revealed no abnormalities, and a physician advised him to take aspirin. The pain resolved, but three weeks before admission, headache, nausea, and vomiting developed and shortly thereafter disappeared; two days later, the patient had a problem with balance. An ultrasonographic study of the liver raised the possibility . . .