Getting to the root of this gardener's sudden paralysis

He had undergone an aortic-valve replacement six months earlier

When a man presented to ED with acute-onset paralysis of the lower legs, doctors went about unearthing the rare cause.

CT angiography
Figure A. The New England Journal of Medicine ©2021.

The 53-year-old gardener also reported a two-month history of intermittent fevers and a bioprosthetic aortic-valve replacement six months earlier.

On examination, the patient was febrile