What's Your Diagnosis

A 46-year-old man with history of diabetes, hypertension, and renal failure presented with high fever, dyspnea on exertion, and pleuritic chest pain. Two weeks earlier, a dialysis catheter had been placed to initiate emergency hemodialysis. Is there a connection to be made here?

A 30-year-old man presented with multiple, mildly pruritic, nonpainful scrotal lesions of 3 months’ duration. He reported a history of similar lesions on 2 occasions, which were removed surgically in another country.

A 56-year old was seen in the ED after 4 days of hemoptysis and intermittent left chest pain. He also complained of exertional dyspnea and arthralgias. He had been treated for “pneumonia” twice during the past month. Histories were unremarkable.

A 47-year-old woman presented with fever of unknown origin. Symptoms included persistent daily fevers (temperature up to 38.8°C [102°F]), weight loss, and severe right flank pain of 3 months’ duration. Review of systems found nausea, rigors, pruritus, and urticaria. She had recently traveled internationally.

A 27-year old woman presented with a subtle discoloration of the lips. The lesions began 1 month earlier following sun exposure. She has no history of similar lesions but described recurrent intraoral lesions and intermittent "enlargement" of the right side of her neck.