A 26 year-old African-American lady was transferred to the intensive care unit (ICU) with severe hypovolemia. She had a two month history of recurrent fevers. The patient did not have any significant medical history and family history was remarkable only for rheumatoid arthritis. Her fever was intermittent and associated with progressively worsening general malaise, early satiety, nausea, and vomiting. There was no recent history of travel or ill contacts. Evaluation by her primary care physician resulted in empiric treatment with multiple courses of oral antibiotics, however, the patient’s condition continued to gradually worsen. Her fever increased in both frequency and intensity reaching over 39.4 oC daily.
Mazen Barbandi, Mohsen Ghadimi-Mahani, Shruti Patel, Joseph Varon
