ID Cases
Cases
Master Infectious Diseases boards through clinical cases, diagnostic reasoning, and high-yield syndrome review.
Latest Cases
Recent cases from IDHub
131 of 131 cases shown•Newest first
Case
The Cavity That Came Back
A Peruvian man treated for TB years ago returns with weight loss, hemoptysis, and an old cavity now containing a fungal ball.
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The Fluke in the Bile Duct
Painless jaundice, a hilar mass, and bile duct flukes in a Korean immigrant with decades of raw fish consumption.
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The Dust That Wouldn't Settle
Subacute basilar meningitis in a Filipino-American construction worker from Arizona.
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The Margin That Moved by the Hour
A healthy gardener develops necrotizing fasciitis with streptococcal toxic shock after a minor abrasion.
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The Border She Couldn't Cross
Choosing malaria chemoprophylaxis when the patient is pregnant and the itinerary hits a resistance border.
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The Shield Down the Drain
Invasive pneumococcal disease as the first clue to an acquired immunodeficiency.
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The PCR That Climbed
A lung transplant recipient's rising CMV viral load despite ganciclovir leads through resistance genotyping, foscarnet toxicity, and ultimately to maribavir.
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The Color of the Cure
A patient on a clofazimine-containing MDR-TB regimen develops progressive purple skin, ichthyosis, and a borderline QTc.
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Undercooked
A veterinary technician with steak tartare, two cats, and three weeks of fever and posterior cervical lymphadenopathy.
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The Negative CrAg
A leukemia patient with cleared candidemia on micafungin develops meningitis with a negative cryptococcal antigen — and a sanctuary-site drug failure.
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The Nerve Below the Surface
Progressive foot drop and hand weakness in an immigrant with no skin lesions — and a diagnosis hiding in the nerves.
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The Cytokine Storm Within
Diffuse lymphadenopathy, a hyperinflammatory state, and plasmablasts in an HIV-positive patient with an enhancing retroperitoneal mass.
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When Mechanisms Collide
Three organisms, three kingdoms, and three antibiotic mechanisms of action tested in a single case of polymicrobial bacteremia from bowel perforation.
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Phase I vs Phase II
Culture-negative endocarditis, seronegative arthralgias, and a serologic pattern that flips the expected phase response.
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The Bite You Didn't Feel
An Amazon traveler returns with a dengue-like illness and a vector most clinicians do not think to ask about.
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Legs from the Bush
A safari traveler returns with fever, regional nodes, and multiple eschars on the legs.
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The Joint Pain Before the Murmur
Culture-negative endocarditis, chronic arthralgias, and PAS-positive macrophages on valve tissue.
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The Culture That Changed the Scope
Subacute endocarditis caused by Streptococcus gallolyticus subsp. gallolyticus leading to discovery of colorectal neoplasia — the strongest organism-disease association in clinical infectious diseases.
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Salt and Iron
Necrotizing fasciitis with hemorrhagic bullae in a fisherman with hemochromatosis after a minor saltwater laceration — curved gram-negative rods and septic shock within 48 hours.
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The Eosinophils Knew
Eosinophilic appendicitis caused by a nematode with pathognomonic lateral alae, discovered on pathology after appendectomy in a young woman.
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Contaminant
A gram-positive coccobacillus dismissed as a diphtheroid contaminant in a patient with advanced HIV and a cavitary lung lesion.
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The Water Was Warm
A previously healthy young man in Texas develops fulminant meningoencephalitis days after swimming in a warm lake, with anosmia and motile trophozoites on CSF wet mount.
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The Daughter Within
A young woman from Patagonia with a large multiloculated liver cyst containing daughter cysts — and a planned biopsy that must not proceed.
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The Report Said Susceptible
Bacteremic cholangitis caused by Klebsiella aerogenes with a deceptively susceptible-looking antibiogram and a cefepime SDD result that demands proper dosing.
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The Nodules Before the Headache
A kidney transplant recipient with recent rejection therapy develops cavitary pulmonary nodules and ring-enhancing brain lesions.
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The Wolf in CoNS Clothing
A destructive native-valve endocarditis caused by a coagulase-negative staphylococcus that should never be dismissed as a contaminant.
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The Summer Temporal Lobe Trap
A 17-year-old with summer encephalitis, temporal PLEDs, hyponatremia, and a negative routine CSF panel.
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The Persistent Burn
Persistent urethritis in a young man after standard GC/CT treatment, with questions on microbiology, NAAT methodology, and resistance-driven sequential therapy.
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The Winter Breakthrough
Severe influenza A after allogeneic HSCT, with questions on viral entry, oseltamivir, and prevention.
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The Unyielding Ring
Ring-enhancing brain lesions in an HIV patient from Bolivia that fail empiric toxoplasmosis therapy.
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The Mulberry Wound
A progressive granular nasal ulcer in a Venezuelan coffee farmer.
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The Waning Shield
A hemodialysis patient with MRSA bacteremia who fails to clear blood cultures on vancomycin — and the mechanism behind it.
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The Brainstem Under Siege
A rituximab-treated adult in Vietnam with brainstem encephalitis, myoclonus, and a characteristic MRI pattern after contact with hand-foot-and-mouth disease.
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What Grew in the Scar
A retired gold miner with progressive massive fibrosis develops constitutional symptoms and a new right upper lobe cavitary lesion on CT.
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A Firestorm After the Cure
A man from the Peruvian Amazon develops abrupt fever, painful nodular crops, neuritis, and orchitis several months after completing multidrug therapy for multibacillary leprosy.
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Fever in the Ozarks
A deer hunter from rural Missouri presents with four days of fever, leukopenia, thrombocytopenia, and transaminitis after removing ticks from his legs.
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The Long Sleep
A humanitarian aid worker presents with cyclical fevers six months after returning from Papua New Guinea despite completing her malaria prophylaxis correctly.
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The Absent Shield
A previously healthy Vietnamese-born woman presents with four months of fevers, weight loss, and massive lymphadenopathy. HIV is negative and CD4 is normal.
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Quiet Enzymes
A kidney transplant recipient on tacrolimus presents with asymptomatic transaminase elevation and a dietary exposure that points away from the usual suspects.
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The Wrong Host
A young man with extensive tropical travel and dog shelter exposure presents with eosinophilia, hepatic lesions, pulmonary infiltrates, and a persistently negative stool exam.
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The Rough Colony
A young man with cystic fibrosis develops progressive pulmonary infiltrates, constitutional symptoms, and subcutaneous nodules five months after bilateral lung transplantation.
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Before Day Forty-Two
A woman with AML develops focal neurological deficits and confusion on day thirteen after allogeneic bone marrow transplantation, before prophylaxis has been started.
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The Fig Tree Fever
A Los Angeles resident develops nine days of fever, headache, and a subtle truncal rash after exposure to cats and backyard wildlife.
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After the Lithotripsy
Bacteremic difficult-to-treat Pseudomonas after urinary instrumentation and residual stone burden.
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The Normal Lung Exam
A young patient develops progressive breathlessness with little to hear on lung exam.
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The Hike and the Tender Node
A camper in California's Sierra Nevada develops fever and a painful inguinal node after a small bite near the ankle.
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Fever after the Coffee Farms
A traveler returning from coffee farms in Tolima, Colombia develops fever, early jaundice, thrombocytopenia, and transaminitis.
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The Negative Test and the Worsening Lungs
An immunosuppressed patient develops progressive multilobar pneumonia despite standard therapy and an initially reassuring test result.
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The Ulcers That Would Not Heal
A stem cell transplant recipient develops progressive mucocutaneous ulceration despite standard antiviral therapy.
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The New Infiltrates on Week Three
A patient receiving outpatient therapy for MRSA bacteremia returns with fever, hypoxemia, and new bilateral pulmonary infiltrates.
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The Gardener's Finger
A gardening injury that did not behave like routine cellulitis.
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The Painful Mouth and the Quiet Lungs
A young woman with severe oral mucositis, minimal skin disease, and subtle pulmonary findings.
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When the Back Pain Came Late
A man develops delayed lumbar pain and constitutional symptoms long after intravesical BCG for urothelial carcinoma. Biopsy reveals granulomatous vertebral infection, and the next step depends on reading the clues correctly.
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When Ceftriaxone Fails
A cirrhotic patient develops persistent VRE bacteremia despite standard ceftriaxone prophylaxis, illustrating why Enterococcus faecium must be interpreted differently from Enterococcus faecalis.
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The Ring in the Right Upper Lobe
A patient with uncontrolled diabetes and diabetic ketoacidosis has a right upper lobe reverse halo sign on chest CT.
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After the Headaches Faded
A patient with advanced HIV develops worsening focal deficits and a left frontal white matter lesion with midline shift after ART initiation.
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Fever and Arthralgia after Caribbean Travel
A traveler returning from the Dominican Republic presents with fever, severe polyarthralgia, and rash. Diagnose and manage this arboviral infection.
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Heart Failure from the Andes
A Colombian immigrant presents with progressive heart failure and characteristic cardiac findings.
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The Shoulder That Wouldn't Heal
Subtle signs and a revealing gram stain lead to the diagnosis of an unusual shoulder infection. Master the key learning points for managing similar cases.
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The 5-Month Mystery
A new murmur and persistent fevers follow heart surgery.
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The Silent Swallow
When aspiration writes a prescription for the brain.
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The Forgotten Toe
A diabetic foot ulcer that wouldn't heal, leading to osteomyelitis and amputation.
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The Sweet Smell of Trouble
Fever, weight loss, and a multiloculated liver abscess — with a blood culture plate that smells like butterscotch.
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The Loyal Companion
Septic shock and meningitis in an asplenic patient whose dog never bit her.
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Fever From the Forest
Fever, rash, and a painless black-crusted ulcer after trekking in rural Nepal.
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Paresthesias in Paradise
Severe headache, migratory paresthesias, and a CSF full of eosinophils after a Hawaiian farm dinner.
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After the Extraction
Acute knee pain in a patient with a prosthetic joint after a dental procedure.
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The Cellulitis That Kept Coming Back
Recurrent leg swelling, a healing inguinal scar, and a blood draw that had to wait until midnight.
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Two Continents, One Smear
Fever, hemolysis, and intraerythrocytic ring forms in an asplenic traveler.
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Lights Out on Postoperative Day 21
Seizure and cortical blindness in a kidney transplant recipient on tacrolimus.
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The Fever That Would Not Wait
TB meningitis in a newly diagnosed HIV patient — treatment timing and ART selection.
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The Plaque Before the Storm
A facial skin lesion that foreshadowed a fatal encephalitis.
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The Breast Mass That Wasn’t Cancer
A suspicious breast mass with a hidden microbiologic cause.
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The Rainy Season Abscess
A diabetic farmer, a draining wound, and a dangerous saprophyte.
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A Shot in the Dark
Choosing the right ART when prevention was an injection.
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Soft Edges and a Swollen Groin
A painful genital ulcer that resists easy categorization.
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The Traveling Edema
Migratory edema after raw seafood exposure.
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Desert Screening Dilemma
An HIV follow-up case.
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When the Fever Breaks
A tropical febrile illness takes a dangerous turn.
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Follicles Beneath the Upper Lid
Chronic conjunctivitis in a child from rural Ethiopia.
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Recurrent Pneumococcemia
Recurrent invasive pneumococcal disease with a subtle hematologic clue.
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Progressive Spastic Paraparesis in a Woman from Guyana
A tropical differential for myelopathy.
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Persistent Diarrhea and Flatulence After Travel to India
Greasy stools, bloating after dairy, and a classic travel-related cause of persistent diarrhea.
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Fever During Alemtuzumab Therapy
An opportunistic infection clue during lymphocyte-depleting therapy.
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Postpartum Fever, Diplopia, and Hemiparesis
A stroke-mimic presentation of postpartum brainstem infection.
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New HIV Diagnosis in a Patient on Hemodialysis
Selecting initial ART in end-stage kidney disease on dialysis.
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Symmetric Groin Plaques in a Man With Diabetes
An intertriginous rash with a key bedside clue.
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Acute Dysentery in a Returning Aid Worker
A high-yield cause of acute bloody diarrhea.
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Severe Hypertension and Renal Failure in Western Mozambique
A tropical cause of bilateral obstructive uropathy and renal failure.
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Jaw Stiffness in a Visitor from Rural Haiti
An early neurologic warning sign with a dangerous trajectory.
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Transient Leg Weakness in a Man from Rural Colombia
Transient deficits, basal cistern lesions, and a hidden tropical diagnosis.
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Persistent Fever, Splinter Hemorrhages, and an Aortic Valve Abscess
A culture-negative endocarditis clue hiding in the exposure history.
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Verrucous Skin Lesions and a Right Upper Lobe Cavitary Opacity
A verrucous arm lesion, diagnostic GMS stain, and right upper lobe pulmonary disease.
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The Climbing Lesion
Not your routine skin and soft tissue infection.
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After the Steroid Burst
ICU shock, pulmonary infiltrates, and diarrhea after immunosuppression.
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A Cheesy Clue
Infectious differential for chronic diarrhea and edema.
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The Case of the Returning Fever
Recurrent fever, jaundice, and a diagnosis hiding in the clothing seams.
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At the Tip of the Nose
A unilateral facial eruption with ocular risk and a misleading early course.
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Fever, Hemolysis, and Bleeding Papules After Andes Travel
A classic biphasic Bartonella bacilliformis syndrome.
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Slowly Progressive Lumbar Mass
When a soft-tissue mass is an indolent infection.
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Chronic Hemoptysis in a Traveler from Rural Colombia
When lung flukes mimic TB.
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A Cryptic Case
When CNS cryptococcosis reveals an acquired immune defect.
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Fulminant Shock
Shock in the Slaughterhouse
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Fever and Cytopenias After Heart Transplant
When the Marrow Goes Quiet
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Headache, Ataxia, and Sixth Nerve Palsy in Connecticut
Brief attachment
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When molluscum is not molluscum
Another skin lesion...
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A Nose Lesion that Wouldn’t Heal
A chronic nasal lesion with a broad differential diagnosis.
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Amazon Adventure
A returning traveler lesion.
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Bloody Diarrhea Without a Clear Cause
An unexpected culprit.
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Fever, Urinary Symptoms, and a Heart Murmur
Beyond the obvious: Gram-positive clusters.
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Hundreds of Lesions
Neglect, poverty, and a devastating skin disease.
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A Dangerous Predilection
A man with a known aortic aneurysm, a forgotten diarrheal illness, and blood cultures that explain everything.
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A Quiet Invasion
A returning traveler with RUQ pain, fever, and a hypodense hepatic lesion — and no culturable bacteria.
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A Stubborn Course
A kidney transplant recipient who completed C. diff treatment but keeps getting worse — the biopsy reveals who was really behind it.
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Fever after Floodwaters
A rice farmer presents with fever, jaundice, and renal failure after wading through floodwaters.
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Forgotten but Not Gone
An unvaccinated adult with bacterial meningitis and a Gram stain that tells the whole story.
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Hidden in Plain Sight
A patient with newly diagnosed HIV, a CD4 of 18, and a bone marrow that told the whole story.
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Memory Lost
A post-BMT patient with progressive amnesia, seizures, and a viral PCR result that demands a second look.
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Not the Cat's Fault
A South Texas woman with cats, a flea, and a fever that didn't need a tick to get started.
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Positive, But Wrong
A neutropenic BMT recipient with a positive CrAg and skin lesions that pointed elsewhere.
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Resistance by Default
Not all vancomycin resistance is created equal.
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The Blinding Cycle
A community health worker in rural Ethiopia with bilateral eye irritation and follicles on the upper tarsal conjunctiva — the world's leading infectious cause of blindness.
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The Copper Penny Sign
A Brazilian farmer with a 3-year verrucous plaque and a pathognomonic tissue finding.
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The Eye of the Rabbit
A hunter from Arkansas who field-dressed a rabbit without gloves now has a red eye, a golf ball-sized preauricular node, and a corneal ulcer that is not pink eye.
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The Great Imitator
A rash that reaches the palms and a genital sore the patient thought had healed.
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The Indeterminate Answer
A man with newly diagnosed HIV and a CD4 of 118 whose household partner has pulmonary TB — and a QuantiFERON result that demands careful interpretation.
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The Long Way Home
A humanitarian aid worker returning from the DRC with progressive neuropsychiatric symptoms and a blood smear that tells the whole story.
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The Mass at Twelve Months
A heart transplant recipient with fever, night sweats, and a left upper lobe mass one year after transplant.
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The Viscous Clue
A diabetic man with endophthalmitis whose blood cultures revealed more than an eye infection.
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The Watercress Fever
A Bolivian immigrant with fever, eosinophilia, and hepatic migratory lesions.
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The Wheel Turns
A nosocomial gastroenteritis outbreak on a surgical ward and a virus whose structure changes everything about how you contain it.
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