Case 29-1963

Presentation of Case First admission. A twenty-five-year-old school-teacher entered the hospital because of chills and fever.Five months before entry the patient experienced chills, fever and malaise, and after these symptoms subsided there were occasional mildly febrile episodes. Six weeks before admission she consulted a physician because of fatigue and was informed that she had a high blood pressure and that intravenous pyelograms were normal. Feverishness, headache and malaise recurred intermittently, and on the day before entry she had a shaking chill, with elevation of the temperature to 104.4°F. The blood pressure was 170 systolic, 100 diastolic; the urine . . .