Case 21-1981

Presentation of Case A 28-year-old man was admitted to the hospital because of hypercalcemia. He was well until 13 months earlier, when fever developed, with a sore throat, cervical lymphadenopathy, nausea, and diarrhea. A throat culture yielded streptococci; penicillin was given for seven days, with improvement. One month later a sore throat and fever recurred. Another throat culture was negative for streptococci, but penicillin was again administered, with improvement during the next two weeks. The patient was fatigued and discontinued his customary vigorous exercise program. Five months before admission he entered another hospital after a third episode of a sore . . .