Daily Archives: November 25, 2015

Question: A 73-year-old male underwent screening colonoscopy. He has lived for a couple of years in Namibia on his farm and has gone several times on hunting safaris in other African countries. He was not aware of any serious diseases in the past excep… Continue reading →

Question: A 77-year-old man with ulcerative colitis was admitted to hospital with a 1-month history of recurrent fevers. He had a long-standing history of ulcerative pancolitis nonresponsive to mesalamine and azathioprine. After developing steroid dependence (minimal prednisone requirement 15 mg/d), he was started on infliximab approximately 4 months before admission, completing infliximab induction therapy (0, 2, and 6 weeks at 5 mg/kg) and receiving his first maintenance infusion (5 mg/kg). At presentation, the patient had multiple symptoms, including (1) recurrent daily fevers and chills, (2) severe bloody diarrhea (>15 bowel movements per day) with urge and tenesmus, and (3) subacute dyspnea and hypoxia requiring 4 L/min supplemental oxygen by nasal cannula. Continue reading →