Case 3

A 44-year-old woman is bought to hospital by her sister who is worried about her. She has felt very hot, had diarrhoea and vomiting and also been confused. She has described seeing things that are not there. Four days ago she underwent an uneventful arthroscopy on her left knee. She has a history of hyperthyroidism but is uncompliant with treatment, has no allergies and no recent foreign travel.