A 70-year-old woman arrives at the hospital with weeks of fever, cough, and night sweats. Antibiotics help some symptoms, but the fevers persist. Extensive investigations turn up clues in her lungs and liver, yet no clear answer.

In this Medical Mysteries episode of Around the Rheum, Dr. Athena Huynh brings the case to hosts Dr. Daniel Ennis and Dr. Janet Pope. They work through the possibilities as new symptoms emerge, weighing what the test results can tell them, which findings might be distractions, and where a biopsy could help.

The conversation follows the case through an unusually long diagnostic journey. Athena, Dan, and Janet reflect on why the answer was so difficult to see at first — and what it means to care for a patient while the disease is still revealing itself.

All in all, this is another great medical mystery that is solved by our team!

Dr. Athena Huynh is a PGY5 rheumatology resident at the University of British Columbia. She brings to the episode a case she encountered during her internal medicine training and has continued to think about since.

Dr. Daniel Ennis is a rheumatologist and clinical faculty member at the University of British Columbia. Dr. Janet Pope is a rheumatologist and Professor of Medicine at Western University.

Around the Rheum is produced by the Canadian Rheumatology Association Communications Committee. The podcast team includes Dr. Dax G. Rumsey, Dr. Daniel Ennis, Dr. Janet Pope, Erin Stewart and David McGuffin of ExploreProductions.ca Theme music is by Aaron Fontwell. Learn more at rheum.ca.