History of Presentation
A 53 year old woman was transferred from her out-patient hemodialysis center to our institution for persistent generalized weakness accompanied by fatigue and abdominal distension. On admission, she is normotensive, non-tachycardic, non-tachypneic, saturating 100% on room air. A faint murmur was present at the left sternal border. A pericardial friction rub was also detected. The abdomen is distended with evidence of ascites. The hospital course was unremarkable until the third hospital day when she developed fever of 100.3F. She has no chills, cough, colds, abdominal pain, dysuria, diarrhea.