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The patient is a 15-year-old male with history of hypercholesterolemia,who was transferred from an
outside hospital after he presented with a five-day history of low-grade temperature, nausea, and
vomiting. He had been seen by his PCP 3 days prior and wasreferred to the outside hospital where he was
given IV fluids, and was subsequently dischargedon promethazine (pr). However, the symptoms did not
improve, and he developed and ataxia andslurred speech, for which he returned to the outside hospital. On
the second admission he had ahead CT scan, which was negative and normal CBC, electrolytes and liver
function tests.Subsequently the patient was transferred to Children's Hospital of Pittsburgh for further
work upand management. A review of the all other sys