Case Published: June 2018
History of Present Illness (HPI)
A 33 year-old man with no known medical problems presents to urgent care complaining of diffuse muscle pain (myalgias) and fatigue. He went to an indoor cycling class a few days ago and though his muscles were sore from the class, but the pain has gotten worse since then despite taking NSAIDs “around the clock.” He also noticed that his urine output has decreased and has appeared darker than usual – he attributes this to dehydration and has been trying to drink more water. He feels mildly short of breath if he walks more than a few blocks and he has felt nauseated.
He says he has not had any fever, chills, vomiting, chest pain, abdominal pain, diarrhea. He does not take any other medications and lives with his partner and their dog. He occasionally drinks alcohol but does not smoke or use illicit substances.
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