Robby

And in the last two days, his right knee started hurting.

Again, like very prominent, painful, barely walking with a limp kind of thing.

Looked a little swollen and was warm apparently.

But yeah, but again, without any sort of preceding trauma or injury.

No other joints other than this knee.

He's got a little headache with the fevers, but nothing sort of very prominent or persistent.

And then still no chest, respiratory, urinary, eye, or GI symptoms other than just like not being able to eat well because of how painful the oral ulcers are.

That was an amazing discussion, both you guys.

And Reza, stating the problem and saying migratory oligoarthritis like you did, you will see is the key to this case.

And Robbie, those are amazing pearls from Kara's perspective.

room conference.

I'm going to keep those.

Okay.

So he does end up seeing rheumatology and infectious diseases in clinic over the next couple of days.

The initial blood cultures, by the way, are negative.

You know, ID had sort of like thought about doing an arthrocentesis, but by the time he sees them, the knee is all better.

They check him for EBV, CMV, HIV, all negative.

His ANA and rheumatoid factor are negative.

He gets a chest x-ray, which is clear, and an abdominal CT that shows prominent inguinal retroperitoneal lymph nodes bilaterally and an 18-centimeter spleen.

ID orders a TTE that's negative.