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Despite the long list of causes of fever and fatigue, I would be most worried about occupationally related illnesses, such as primary human immunodeficiency virus (HIV) infection and hepatitis in its prodromal phase.
The fevers usually occurred at the end of the day and were associated with myalgias and chills. The patient began to take acetaminophen. He was seen at a local emergency room for epigastric pain, where a physical examination,
Commentary
Source Information
From the Department of Medicine, New England Medical Center, Tufts University School of Medicine, Boston.
Address reprint requests to Dr. Pauker at New England Medical Center, Box 302, 750 Washington St., Boston, MA 02111, or at stephen.pauker@es.nemc.org.
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