Clinical Problem Solving And The Division Of Infectious Disease

2961 WordsDec 15, 201612 Pages
Clinical Problem-Solving ?Coming Home? Maralyssa Bann, MD Daniel R. Kaul, MD Mahri Z. Haider, MD, MPH Sanjay Saint, MD, MPH Zachary D. Goldberger, MD From the Department of Medicine (MB, MZH, ZDG), Divisions of General Internal Medicine (MB, MZH), and Cardiology (ZDG), University of Washington School of Medicine, Harborview Medical Center, Seattle; the Department of Internal Medicine (SS, DRK), the Division of Infectious Disease (DRK), University of Michigan Medical School, and the Department of Veterans Affairs Health Services Research and Development Center of Excellence (SS), Ann Arbor. Address reprint requests to: Zachary D. Goldberger, MD, MS University of Washington 325 9th Avenue, Box 359740 Seattle, WA 98104 Email: zgoldber@uw.edu Phone: 206 744-8712 Fax: 206 744-2224 Word Count: 2480 References: 15 A 25-year-old woman presented to the emergency department with two days of fever, chills, and sweats. These symptoms began abruptly, and were accompanied by malaise, headache, dry cough, myalgias, and decreased appetite. She denied photophobia, neck stiffness, chest pain, dyspnea, nausea, vomiting, abdominal pain, or dysuria. While the symptoms are non-specific, an infectious cause is most likely given the relatively abrupt onset of fever, chills, sweats, malaise, and myalgias. Further details of her past medical history, possible recent exposures, and a physical examination including vital signs will help determine whether further testing and empiric antimicrobial

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