Hey, folks, just a quick reminder that this podcast is not meant to be used for medical advice,

just good old-fashioned education.

Welcome to another episode of the clinical problem solvers.

Sorry, my voice just went high pitch.

Robbie, how are you doing today? I'm terrific, man. I'm really psyched. So Robbie, you just presented a case to me. So now I get to return the favor.

So let me just orient the audience. Today I'm going to be presenting an unknown case to Robbie.

So Robbie has not seen the case before tonight, and he's going to try to solve it in real time.

And it's not about getting the diagnosis.

It's more so the journey to the final diagnosis.

Now, that is true unless Robbie gets the diagnosis, and then it's all about the

diagnosis. All right, Robbie. Should we kick it off? All right, let's do it. Good luck, man.

Thank you, sir. Okay. A 25-year-old woman presented with two weeks of fever, drenching night sweats,

and decreased oral intake.

Two weeks ago, she developed fevers of 102 degrees Fahrenheit, chills, myalgia, and fatigue.

Despite Tylenol and Motrin, she continued to have fevers and chills.

She had a faint erytheminist rash during her episodes of fever. She also had left

upper quadrant pain over the past week. She went to a local urgent care where flu was ruled out.

Her last travel outside the U.S. was to Nepal in 2016. She had received appropriate chemoprophylaxis at that time.

She had no exposure to farm animals or their products.

In early September, she went on a few nature walks in the forest with her sister.

She had no sick contacts.

She had no chest pain, dysmia, cough, diarrhea, or urinary symptoms.

...