In this week’s Clinical Problem-Solving Case, a 58-year-old man with nonerosive rheumatoid arthritis who was being treated with etanercept and methotrexate presented to the emergency department with a 2-week history of fevers (temperatures up to 39°C) and drenching night sweats. In the previous week, yellowing of his eyes and dark urine had developed. He reported no dyspnea, abdominal pain or distention, nausea, vomiting, dysuria, easy bruising, headache, or myalgias. What should be done? A new Clinical Problem-Solving article explains.
In this Journal feature, information about a real patient is presented in stages to an expert clinician, who responds to the information, sharing his or her reasoning with the reader. Click to read more about this case, including expert author commentary, on NEJM Resident 360.