Abstract
1. Diana Weaver, MD* 2. Valeriy Chorny, MD* 3. Sayani Tewari, MBBS* 1. *Kings County Hospital Center, SUNY Downstate Medical Center, Brooklyn, NY. A 17-year-old boy with intellectual disability, epilepsy, asthma, diabetes mellitus type 2, and thyroiditis is readmitted for seizures, persistent cough, shortness of breath, and persistent pleural effusion on chest radiograph. He has constant chest and joint pain and a gait abnormality. Before the current hospitalization, he presented to the clinic with 2 weeks of productive cough and received azithromycin. Seventeen days later, he was admitted for cough and progressive worsening of fatigue; muscle, back, abdominal, and chest pains; unintentional weight loss; and a 9-month history of joint pains and gait change described as “walking like an old man.” A chest radiograph and chest computed tomography (CT) scan revealed a small right pleural effusion with nonspecific right lower lobe ground-glass opacities and no hilar lymphadenopathy. He was treated for possible pneumonia and discharged after 3 days. He was afebrile throughout his hospital course. His daily medications include metformin 1,000 mg/day, levothyroxine 50 μg/day, topiramate 400 mg/day, and oxcarbazepine 1,800 mg/day (started 10 months ago). Physical examination reveals temperature of 100°F (37.7°C), respiratory rate of 26 breaths/min, heart rate of 88 beats/min, blood pressure of 118/71 mm Hg, and room air oxygen saturation of 93%. Examination of the …
Published Version
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