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Dr. Sheila F. Mitsuma (Department of Medicine): A 60-year-old man was admitted to this hospital because of fever, odynophagia, weight loss, and rash.
He had been well until 5 months earlier, when he began to have fatigue and malaise, as well as decreased appetite, and he lost 7.3 kg of weight. Four weeks before admission, a constant ache developed in the upper oropharynx, which was exacerbated by swallowing. It was accompanied by a dry cough and diffuse arthralgias and myalgias. Two weeks before admission, the patient saw his primary care provider, who prescribed amoxicillin. The symptoms persisted, and a pruritic,
Differential Diagnosis
Infectious Diseases
Neoplasms
Hypersensitivity and Autoimmune Diseases
Systemic Lupus Erythematosus
Dr. Mandakolathur R. Murali's Diagnosis
Pathological Discussion
Anatomical Diagnoses
Source Information
From the Departments of Medicine (M.R.M.), Dermatology (B.T.M.), Radiology (V.V.M.), and Pathology (A.Z., J.A.F.), Massachusetts General Hospital; and the Departments of Medicine (M.R.M.), Dermatology (B.T.M.), Radiology (V.V.M.), and Pathology (A.Z., J.A.F.), Harvard Medical School.
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