Case Report

A 19 year old African-American male with no significant past medical history presented to an outside hospital with two days of diffuse abdominal pain, myalgias, muscle weakness, and darkurine. Two weeks prior to presentation, the patient was treated as an outpatient with an unknown antibiotic for symptoms of a sore throat, nausea, and non-bloody, non-bilious emesis. The patient denied any sick contacts, recent travel, trauma, strenuousexercise, or the use of non-steroidal anti-inflammatory drugs, acetaminophen, alcohol, or illicit drugs. The patient reported being sexually active with one female partner and had no historyof sexually transmitted infections. The patient was employed at a daycare center.