Case 26-2007 -- A 61-Year-Old Man with Recurrent Fevers

doi:10.1056/NEJMcpc079020

Volume 357:807-816		August 23, 2007		Number 8

Case 26-2007 — A 61-Year-Old Man with Recurrent Fevers

Gregg S. Meyer, M.D., Charles A. Hales, M.D., Philip C. Amrein, M.D., Amita Sharma, M.D., and Richard L. Kradin, M.D.

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Presentation of Case

Dr. James J. Tolle (Pulmonary and Critical Care Medicine): A61-year-old man was admitted to this hospital because of recurrentfevers. He had been well until approximately 3.5 months earlier,when chills, fevers, and fatigue developed. He had no coughor production of sputum. He saw his primary care physician,who sent him to the emergency department of another hospital.A chest radiograph revealed a left basilar opacity, and a diagnosisof community-acquired pneumonia was made. A 5-day course ofazithromycin was begun.

His symptoms persisted, and he was admitted to the same hospital5 days later. A chest radiograph . . . [Full Text of this Article]

Differential Diagnosis

Possible Causes of Fever of Unknown Origin

Infection

Cancer

Autoimmune disorders

Clinical Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis

Source Information

From the Department of Medicine (G.S.M.), the Pulmonary Unit (C.A.H.), and the Departments of Hematology–Oncology (P.C.A.), Radiology (A.S.), and Pathology (R.L.K.), Massachusetts General Hospital; and the Departments of Medicine (G.S.M., C.A.H., P.C.A.), Radiology (A.S.), and Pathology (R.L.K.), Harvard Medical School.