Case 21-1998

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Abstract
Presentation of CaseA 32-year-old woman was admitted to the hospital because of paresthesias and pharyngeal spasms.The patient had been in excellent health until 68 days earlier, when she was bitten by a dog in Nepal. She received only first aid. The wound healed uneventfully. Thereafter, she was well until two days before admission, when she began to have severe “shooting pains” in the left arm, followed by numbness in the bitten area. A physician in an emergency room prescribed acetaminophen–codeine and a nonsteroidal antiinflammatory drug. Mild headache, low-grade fever, malaise, nausea, and vomiting followed, and during the two . . .