Worms Up My Arms!

Author: Sara Ahmed / Editor: Nick Tilbury / Codes: / Published: 01/06/2022

A 50-year-old male is brought in by ambulance with a history of acute confusion. His neighbours called the ambulance as they heard loud noises. The patient is acting aggressively and tells you that worms are crawling up my arms. He says he has also vomited earlier that day and is still nauseated.

His heart rate is 130 bpm and his blood pressure is 190/100. He also has a temperature of 40 degrees. He is sweaty, flushed and tremulous. On examination you discover mydriasis, dry eyes, diplopia, hyper-reflexia and rigidity.

His ECG shows sinus tachycardia with a normal QTC.

The patient admits to having taken a cocktail of drugs along with alcohol with the intention of ending his life. He has been treated with Intravenous diazepam and reviewed by mental health team.

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