Bad to the Bone.

A 52-year-old man presented to the emergency department with nausea, vomiting, and profound lethargy. He had noted mild nausea and fatigue for approximately 5 months. Given acute worsening of his symptoms in the days leading up to presentation, he sought medical care. He reported no associated fever, diarrhea, or abdominal pain but had had a weight loss of approximately 7 kg since the onset of symptoms. . . .