| Summary points: | A 76-year-old presents with a 5-week history of fatigue, poor appetite, urinary frequency, vomiting and low back pain. This case reviews patient history, which includes rheumatic heart disease, pulmonary tuberculosis, chronic atrial fibrillation, hypertension, recurrent cystitis and bilateral hip replacements. The authors discuss patient's physical and test findings, initial treatment, follow-up testing, diagnosis and patient management. |