Remote follow-up

This is a case from late October but I still like it because of the pictures. This was the 65 y/o man with CHF (EF~25-30%) with 6 weeks of daily fevers with arthralgias who had been admitted twice with multiple negative Cxs and no diagnosis yet. He had the Janeway lesions on palms and soles and we treated him for culture-negative endocarditis/endovascular infection. He was just re-admitted with syncope (likely related to his BP meds) and hisskin lesions haave completely resolved. His ESR has come down from 115 to 30 and he has been afebrile for weeks with no recurrence. All of his cultures and serologies were non-diagnotic.