中英临床推理73岁男性，患有结节

SECTION1:CLINICALPRESENTATION

第一部分：临床表现

A73-year-oldmanwasadmittedforevaluationofacuteischemicstrokes.Hismedicalhistorywasnotableforpulmonarysarcoidosistreatedwithoralprednisone40mgdaily,type2diabetesmellitus,hypertension,andhyperlipidemia.Approximately1monthpriortoadmission,heunderwentelectiverighttotalkneearthroplastyatanoutsideinstitutionand1weekpostoperativelydevelopedacutedeliriumandfluctuatingfevers.Noinfectiouscausewasidentified.HismentalstatuscontinuedtodeclineandheadMRIwasobtained(figure,A),showingsmallacuteinfarctsinmultiplevascularterritories.

73岁男性，因诊断“急性缺血性脑卒中”入院。既往病史包括：肺结节病，口服泼尼松40mg/日治疗，2型糖尿病、高血压病及高脂血症。距此次入院约1月前，患者曾于外院行择期右侧全膝关节置换术，并于术后1周出现了急性谵妄和波动性发热，未发现明确的感染病因。患者的精神状况逐步下降，头颅MRI检查可见多血管供血区的多发急性小梗死灶。

Hebeganhavingepisodesofforcedeyedeviationandbehavioralarrestlastinglessthan30secondseach.Hewasurgentlyadmittedtoourhospitalandlevetiracetamwasstartedempirically,withoutrecurrenceofpresumedseizures.He







































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