Also known as: Heart valve infection
William, a Renaissance fair performer, develops endocarditis on his heart valve caused by anabolic steroid abuse. The infection causes erratic heart rate requiring cardioversion and contributes to his deteriorating condition throughout the episode.
Also known as: Blood-filled cysts in liver
William presents with blood-filled lesions in his liver that initially appear to be tumors on ultrasound. These are ultimately revealed to be peliosis hepatis caused by chronic anabolic steroid use.
Also known as: Rhabdo
William develops rhabdomyolysis with severe leg pain described as feeling 'on fire,' leading to kidney failure. This is a complication of his anabolic steroid abuse.
William is exposed to hemlock (containing piperidine alkaloids) through a food challenge at the Renaissance fair. While trace amounts are found in his blood, this accelerates but does not primarily cause his condition.
Also known as: Seizure
William has a seizure during a jousting match at the Renaissance fair, which is his initial presenting symptom that brings him to the hospital.
Also known as: Bloody tear
William presents with hemorrhaging in the sclerae (described as 'demon eyes'), which is one of several symptoms that leads the team through various diagnostic possibilities.