Case Presentation A 53-year-old man presented to the clinic with a 2-week history of back pain, stiff neck, headache, and fever. The patient also reported a 3-day history of right knee pain and swelling. Past Medical History The patient had pseudogout and a kidney transplant 13 years ago.
He was on sirolimus and prednisone medication in order to prevent rejection of the transplanted organ. Physical Examination Body Temperature: 38.9°C Presence of nuchal rigidity and positive Kernig sign No focal neurologic deficits and no spinal tenderness was observed Presence of right knee effusion (without erythema) and a full range of motion observed Laboratory Examination WBC: 10200/μL (neutrophils, 63.8%; lymphocytes, 19.6%; monocytes, 15.1%) ESR: 63 mm/h RBCs: 32/μL Total protein level: 109 mg/dL Glucose level: 59 mg/dL Radiological Imaging MRI of the spine revealed cervical degenerative changes…
