Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.
Background
A 61-year-old man presents to the emergency department (ED) with fever, dyspnea and a productive cough for 1 week that has failed to respond to outpatient antibiotics (levofloxacin). He also complains of worsening arthralgias in both lower extremities, particularly in his knees and ankles, as well as a 10-lb (4.54-kg) weight loss over the preceding 2 months. He is a former smoker with an 80-pack-year history. No other significant medical history is noted. He denies any recent travel, sick contacts, or occupational exposure to asbestos or mineral dust. His only medications include over-the-counter analgesics for joint pains, and he denies having any drug allergies.
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Cite this: Twinkle R. Chandak. A Patient With Pneumonia and Arthralgias - Medscape - Apr 07, 2010.
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