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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 338:1830-1836 June 18, 1998 Number 25
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Case 19-1998— A 70-Year-Old Man with Diarrhea, Polyarthritis, and a History of Reiter's Syndrome
Robert H. Shmerling, and Angela M. Caliendo

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Presentation of Case

A 70-year-old man was admitted to the hospital because of polyarthritis.

The patient had been well until 13 days earlier, when he began a 3-day course of treatment with cefixime because of a root-canal operation. Watery diarrhea developed four days later. He took diphenoxylate and then flew to Europe for a one-week vacation. Mild diarrhea continued. Five days before admission, while the patient was still on vacation, his left knee became stiff, painful, and swollen. The next day, these symptoms were worse, and chilliness and night sweats developed. He began a two-day course of treatment with azithromycin. Three days before . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnoses

Dr. Robert H. Shmerling's Diagnoses

Pathological Discussion

Anatomical Diagnosis

Addendum

References



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