Case History and Presentation:
A 24-year-old female with a history of migraines and menorrhagia presented to an urgent care center in late summer 2020, complaining of fever, fatigue, and unintentional weight loss. The review of systems was positive for generalized weakness and dizziness. She denied bone pain, chronic diarrhea, recurrent infections, Raynaud’s, pleurisy, palpitations, skin rashes, photosensitivity, alopecia, seizures, sicca, or palpable adenopathy. Her social history was remarkable for drinking alcohol every other day from October 2019 to the end of the summer of 2020, cocaine use in the past, and being a former smoker. Her past surgical history is remarkable for bilateral adenoidectomy. Her vital signs were typical. The physical exam was grossly unremarkable.