text:  He was a chronically ill appearing elderly man   with a respiratory rate of 30   temperature 99.6   pulse 100   and irregularly irregular   blood pressure 148  71 . He had some petechiae on his extremities   as well as in his mucosal membranes with some hemorrhagic bullae . There were bibasilar rales with some wheezing . He had no cardiac murmur . His abdomen was distended with massive hepatosplenomegaly   which was somewhat tender . The neurological examination aside from the blind right eye was unremarkable .