A 46-year-old female, with a past medical history significant for hypothyroidism and beta-thalassemia, who was otherwise healthy until two weeks prior to admission. At that time, she noted onset of a sore throat, malaise, and low-grade fevers. Four days prior to admission, she experienced fever to 104 o F, chills, nausea and vomiting, and arthralgias and myalgias. She presented to the Emergency Room.
Past Medical History: Chronic anemia due to beta-thalassemia Hyperthyroidism S/P 125I treatment with resulting hypothyroidism History of benign systolic ejection murmur for 15 years Physical Examination: The patient was noted to be ill-appearing. Vital signs: Temp 98.8F, pulse 102, resp 16, BP 100/70. Her exam revealed mild pharyngeal erythema but no exudate, shoddy anterior cervical lymphadenopathy, a 2/6 systolic ejection murmur that was non-radiating, and mild diffuse abdominal…
