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Case Records of the Massachusetts General Hospital
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Volume 356:2631-2637 June 21, 2007 Number 25
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Case 19-2007 — A 19-Year-Old College Student with Fever and Joint Pain
Benjamin T. Davis, M.D., and Mark S. Pasternack, M.D.

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Presentation of Case

Dr. Maxwell T. Vergo (Department of Medicine): A 19-year-old woman was transferred to this hospital because of joint pain, fever, and hypotension.

The patient, a freshman student at a local university, had been in good health until the late spring, approximately 11 days before admission, when sore throat and fatigue developed. She was evaluated at the university health service. A Monospot test was positive, and a rapid screening test for group A streptococcus was negative; a diagnosis of infectious mononucleosis was made. The results of laboratory tests are shown in Table 1. One week before admission, nasal congestion and . . . [Full Text of this Article]

Differential Diagnosis

Oral Ulcers

Pain in the Ear

Gastrointestinal Symptoms

Arthralgias, Fever, and Hypotension

            Differential Diagnosis of Acute Joint Inflammation

            Reactive Arthritis

            Septic Arthritis

            Gonococcal Arthritis

Clinical Diagnosis

Dr. Benjamin T. Davis's Diagnosis

Pathological Discussion

Anatomical Diagnoses


Source Information

From the Division of Infectious Diseases (B.T.D., M.S.P.), and the Department of Pediatrics (M.S.P.), Massachusetts General Hospital; and the Departments of Medicine (B.T.D.) and Pediatrics (M.S.P.), Harvard Medical School.


Related Letters:

Case 19-2007: A College Student with Fever and Joint Pain
Spadafora R., Altschuler E., Hon A., Huang A., Santos B. T., Gonzalez G. S., Pasternack M. S.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:1779-1780, Oct 25, 2007. Correspondence

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