A Can’t-Miss Diagnosis at an Unusual Age: An Adolescent with Granulomatosis with Polyangiitis

Case Description: A 16-year-old previously healthy male presented with acute onset, right-sided pleuritic chest pain. The pain was preceded by two days of non-productive cough, two weeks of night sweats, and an 18-pound weight loss in one year. He denied fevers but admitted to vaping tobacco and THC. He denied sick contacts and travel but had been living in a group home for three years. On arrival, he was tachycardic and tachypneic but afebrile. He was diaphoretic and breathing shallowly. On auscultation, …