ABSTRACT
A 27-year-old man was referred to the emergency department by his general practitioner (GP) to investigate a 6–8 week history of intermittent left-sided chest pain, fevers, night sweats and weight loss. The chest pain was pleuritic in nature and was generally present when the patient exerted himself. He had noticed fevers and chills throughout the day and was experiencing drenching night sweats when sleeping. The patient weighed himself regularly at his local gym and stated that he had unintentionally lost 18 kg weight in the preceding 6 weeks. He had also experienced lower back pain over the past 4 weeks and had tried multiple analgesic agents with minimal improvement. His past history included hypertension and depression. He took 5 mg amlodipine daily. He was Ghanaian and had come to the United Kingdom 20 years ago with no foreign travel since. He worked in a launderette and lived with his wife, who had suffered from tuberculosis in childhood. He had never smoked tobacco and denied regular consumption of alcohol or use of recreational drugs. His wife and colleagues were, to his knowledge, not experiencing similar symptoms.
