%0 Journal Article %T February 2013 pulmonary case of the month: one thing leads to another %A Poulos E %A Peterson E %A Raschke RA %J Southwest Journal of Pulmonary and Critical Care %D 2013 %I Arizona Thoracic Society %X No abstract available. Article truncated at 150 words. History of Present IllnessA 63 year-old man from Minnesota with a history of sarcoidosis managed with low-dose prednisone (average 6 mg/day with periodic bursts) for the past 15 years was transferred to our hospital for a higher level of care. Eight weeks prior to admission he was in Costa Rica for a 3 week vacation where he engulfed himself in local traditions, swam in marine and fresh water, slept in rural areas, ate unprocessed foods, wore no insect repellent and had no prophylactic vaccines or medications. He returned to northern Minnesota and visited his cabin where he noted numerous dog tics. Four weeks prior to admission he developed intermittent fevers to 102бу, rigors and drenching night sweats. Workup initiated in Minnesota was unrevealing. Specifically he had negative malaria smears, blood cultures, leptospirosis and hepatitis panels. Transaminases were elevated in the 100s. An empiric 1 week trial of doxycycline resulted бн %K sarcoidosis %K histoplasmosis %K pneumonia %K immunocompromised host %K hemophagocytic lymphohistiocytosis %K etoposide %K pancytopenia %K ferritin %U http://www.swjpcc.com/pulmonary/2013/2/1/february-2013-pulmonary-case-of-the-month-one-thing-leads-to.html