Case 28-1993

Presentation of Case A 63-year-old man was admitted to the hospital because of fever, chills, and fatigue. The patient had been in stable health until 17 days earlier, when he experienced the onset of dull occipital headache, myalgias, and night sweats. He used analgesic medications intermittently, with transient improvement in his symptoms, but did not check his temperature during the first two weeks of the illness. The myalgias disappeared after two weeks. During the third week of symptoms the patient found that his temperature became elevated, usually at night, and rose as high as 39.3 °C; he also observed that . . .