Show Summary Details
Page of

Case 29 

Case 29
Case 29

Joel David

, Anne Miller

, Anushka Soni

, and Lyn Williamson

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 23 October 2019

A 36-year-old previously fit green-keeper at a golf course was admitted to the infectious diseases unit with a 5-week history of puffy hands, weakness of the arms and legs, and fatigue. He was finding it difficult to stand from sitting and had episodes of night-time fever. There was no travel history. He owned a dog. There was no history of tick bites, no contact with other individuals with a similar history, no past medical history, and no relevant family history. He had been a smoker of 15 cigarettes a day since age 19 years. Specific enquiry excluded Raynaud’s syndrome, dryness of eyes or mouth, rashes, or difficulty in swallowing and there was no change in bowel habit.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.