Last updated on: February 14th, 2021

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You’re looking at an interactive case study from Prognosis: Your Diagnosis (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.



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A 22-year-old woman presents with diplopia since waking up an hour ago. She has had a worsening retro-orbital headache for three days and a high fever for four days. She has not obtained medical attention so far, but has self-medicated herself with ibuprofen.

She was diagnosed with type I diabetes mellitus four years ago and is on insulin. Her glycemic control has been poor due to a lack of compliance with lifestyle measures and the insulin regimen. She was diagnosed with grade I diabetic retinopathy six months ago. Her medical history is unremarkable otherwise. She is not on any other medications. Her surgical, family, and allergic histories are also unremarkable.

A random capillary glucose is 306 mg/dL (17 mmol/L).

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