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Q Fever, CNS Vasculitis, and Stroke: A Case Report
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. Magnetic resonance imaging of the brain revealed extensive, bilateral ischemic strokes (Figure). A transesophageal echocardiogram was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - May 27, 2020 Category: General Medicine Authors: Jason Maljaars, Santiago Ortega-Gutierrez, Tracey Cho, Amir Shaban Tags: Clinical Communication to the Editor Source Type: research

A Case of Acute Ischemic Stroke and CNS vasculitis in a Patient with Q Fever
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. A brain MRI revealed extensive, bilateral ischemic strokes (Figure 1). A transesophageal echocardiogram (TEE) was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - May 27, 2020 Category: General Medicine Authors: Jason Maljaars, Santiago Ortega-Gutierrez, Tracey Cho, Amir Shaban Tags: Clinical Communication to the Editor Source Type: research