Infectious Disease

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A 58-year-old man presents with myalgias of approximately 1 week’s duration. He had been recently treated for sinusitis and symptoms resolved. His only medications were hydrochlorothiazide for hypertension and simvastatin for hyperlipidemia. He and his wife had gone camping 1 month before this visit.

A woman in her 20’s presents for care after 9 days of sore throat and subjective fevers followed by neck stiffness that developed over the last 2 to 3 days. The pain is exacerbated by swallowing and any neck motion. She has had sore throats before, but never this bad or this long and never that made her neck stiff.

A 47-year-old man in no apparent distress presented with intermittent facial pain, involuntary right facial muscle contractions, bilateral muscle spasms, trismus, involuntary tongue protrusions, tongue trauma, and an excessive gag reflex. He had taped a pacifier to his face to prevent tongue damage during involuntary clenching.

A 66-year-old woman is concerned about a gradually increasing rash located on the buttocks, lower back, abdomen, and upper, posterior thighs. The eruption has been present at least 18 months and is mildly pruritic.

Looking for Pinworms

A tip for identifying pinworm infections in pediatric patients.

Although this patient has been treated by several health care providers for this expanding lesion on his scalp, nothing has worked. The pathology is clearly outside the “normal” realm. What’s going on?

A 50-year-old African American woman with type 2 diabetes mellitus and hypertension was admitted with constant bilateral knee and thigh pain and swelling of both knees, all of 1 week’s duration. The pain was not relieved with hydrocodone/acetaminophen and had caused weakness and subsequent falls.