Case 1

The patient is a 71-year-old female with past medical history significant for hypothyroidism and hyperlipidemia who presented to Thomas Jefferson University Hospital (TJUH) with complaints of myalgias for 6 weeks duration. The patient stated that she had begun an exercise program to lose weight and had subsequently noticed body aches and increased fatigue. She had presented to an outside hospital with these complaints, was told that the etiology was musculoskeletal, and was prescribed naproxen for pain relief. The pain did improve slightly with the naproxen but she noticed a rash and hives after starting the medication and stopped taking it. Her symptoms continued for about 6 weeks and she decided to come to our emergency department when she was unable to obtain an appointment with her primary care physician. She also noted that 2 days prior to admission she had an increase in her temperature to 100˚ F. She had been feeling fevers since this time coupled with chills and sweating. The fevers were not cyclic in nature.