Case 105

1. Presented by: Eitan Halper-Stromberg, MD

An adult patient with a past medical history of HgSS, alloimmunization to several red cell antigens, functional asplenia, iron overload, and transfusion dependence presents to the clinic with headache and fever. They have not traveled in the last six months. They live in a grassy locale; however, are not given to hikes or wooded excursions. Several weeks ago, the patient developed neck pain and daily fevers. In the last week the neck pain has become progressively worse and is accompanied by decreased range of motion of the neck and jaw, as well as photophobia. Physical exam is positive for fever (103 F). Review of systems is positive for fevers, chills, loss of appetite, and headache. Labs are notable for WBC 5.6, Hgb 11.2, MCV 75, AST 112, ALT 123, CRP 6.4, ESR 30, and LDH 542. Lyme and Hepatitis serologies are negative. Red cell antibody screen is positive. Ehrlichia IgG is positive. EBV IgG is positive for both nuclear and capsid antigens. The peripheral smear is shown.



What is the likely diagnosis?

 

33 thoughts on “Case 105”

  1. I гeally like what you guys are usually up too.
    Such clever work and exposure! Keep up the excellent works
    guys I’ve inclᥙded you guys to blogroll.

  2. I can’t thank you enough for the wealth of information and resources available on this website. The information provided has been a game-changer for me, and I’m truly grateful. The information provided is reliable, up-to-date, and presented in a user-friendly manner. I’m grateful for the valuable insights I’ve gained from this platform. Great thanks! ID : CMT-CSIUB4AYBXE8ATF2J8

  3. Good day! This is my first visit to your blog!
    We are a collection of volunteers and starting a new
    initiative in a community in the same niche.

    Your blog provided us valuable information to work on. You have
    done a wonderful job!

  4. Fine way of telling, and nice piece of writing to get information on the topic of my presentation subject, which i am going to
    convey in institution of higher education.

  5. naturally like your website however you have to test the spelling on several of your posts.

    A number of them are rife with spelling problems and I in finding it very bothersome to tell the reality nevertheless I’ll certainly come back again.

Leave a Reply

Your email address will not be published. Required fields are marked *