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Previous Volume 353:1956-1961 November 3, 2005 Number 18 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.

A 21-year-old male college student presented to the student health center after two days of extreme fatigue. Over the course of the previous two months, frequent headaches, difficulty concentrating, and a decrease in his capacity for exercise had developed. He recently had had several days of nasal congestion and sore throat, but these symptoms had improved. A cursory physical examination showed no . . . [Full Text of this Article]

Commentary

Source Information

From the Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver (W.J.J.); the Department of Medicine, University of California, San Francisco, San Francisco (H.R.C.); the Department of Veterans Affairs Health Services Research and Development Center of Excellence, and the Department of Medicine, University of Michigan — both in Ann Arbor (S.S.); and the American College of Physicians, Philadelphia (S.E.W.).

Address reprint requests to Dr. Janssen at the University of Colorado Health Sciences Center, 4200 East 9th Ave., Box C-272, Denver, CO 80262, or at william.janssen@uchsc.edu.

Related Letters:

A Perfect Storm
Lam A. M., Janssen W. J., Saint S., Weinberger S.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:977-978, Mar 2, 2006. Correspondence

This article has been cited by other articles:

• Lam, A. M., Janssen, W. J., Saint, S., Weinberger, S. (2006). A perfect storm.. NEJM 354: 977-978 [Full Text]