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

just good old-fashioned education, and all patient information has been modified to protect their identity.

Welcome back clinical problem solvers to another week of human diagnosis cases.

My name is Anand Jagannath.

I'm a clinician educator and hospitalist at the VA in San Diego, where I see patients,

teach residents, and medical students, and try to convince everyone how awesome clinical reasoning is.

I'm very excited for today's episode.

I'm here today with Lindsay Shipley, a second-year resident at the Tinsley-Harrison Internal Medicine Residency Program at the University of Alabama, Birmingham. How are you, Lindsay? Hi, Anand. I'm doing great. Thanks for asking. I'm really excited to be here today. I was first introduced to you guys by listening to the curbsiders, and I've been a huge

fan ever since listening to your cases and working through them with you. And I was introduced to

you guys ultimately by Dr. Centaur, one of my mentors at UAP. So I'm really happy to be here.

I'm also joined by my colleague, Mariana. Mariana, how are you today? Hi, Lindsay. Hi,

everyone. I'm great. I'm very happy to be here today. I'm also a fan and was also introduced to the

podcast through the curbsiders and Dr. Centwar. I'm also a second year resident at UAB. I forgot to say

that. Terrific. What an all-star crew. Mariana, Lindsay, and Anand, it's such a delight to have

you, and I'm really, really excited to jump into this human diagnosis case together.

This is a quick reminder. In these episodes, trainees at all levels come and hang out with us

at the clinical problem solvers and tackle these human diagnosis unknown cases.

We're really excited to welcome trainees from programs across the country to join us on the show, as we have two residents from UAB here with us today. If you are a trainee and are interested in this, please have your program contact us at the clinical problem solvers at gmail.com. If you're an educator or part of program leadership, please do the same.

All right, Anand, take it away.

A 39-year-old man is admitted to the hospital with a cough.

He reports five days of subjective fevers and productive cough in the setting of multiple family members who are also ill.

His vital signs in the emergency room were temperature of 100.9, heart rate 116, blood pressure 132 over 73, respiratory rate 16,

...