Lisa M Sutton, MD; Rita Gander, PhD; Paula Revell, PhD; Paul Southern, MDAuthor Information
Clinical History
Patient
8-year-old male.
Chief Complaint
Fever for 2 weeks and migrating arthralgias.
History of Present Illness
The patient presented with daily cyclic fevers that started after returning from a 2.5-month trip to Dhaka, Bangladesh, to visit family. While in Bangladesh, he developed shoulder pain which migrated to multiple other joints. He complained currently of bilateral thigh pain. He also mentioned that he had had mild nausea, vomiting, decreased appetite, and cough for several weeks.
Past Medical History
None.
Immunizations
Up to date.
Family/Social History
Noncontributory.
Medications
Ibuprofen for arthralgias and fever.
Physical Examination
The patient appeared febrile, but was in no acute distress. His temperature was 40.5B0C, and he was mildly tachycardic, with a heart rate of 109 bpm. The remainder of his vital signs were within normal limits. Head, ears, eyes, nose, and throat were all unremarkable, with no scleral icterus or lymphadenopathy noted. The cardiovascular system was normal, and his lungs were clear to auscultation. His abdomen was tender to palpation with no organomegaly noted. No skin rash was present. His extremities were tender to palpation, with no obvious joint deformities. His neurologic exam was unremarkable.
Section 1 of 2
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