title: Case report of atypical Still's disease: a diagnosis of exclusion.
abstract: BACKGROUND
  We present an unusual presentation of a 39-year-old man with myalgias and shortness of breath.
  The patient presented to the emergency department with complaints of myalgias, shortness of breath and palpitations. During this hospitalization, he had multiple episodes of tachycardia and desaturation. The patient had elevated troponins and creatinine kinase. Differential diagnosis included pericarditis, pneumonia and malignancy.
  
  
  METHODS
  The patient had elevated ferritin and erythrocyte sedimentation rate.
  
  
  RESULTS
  The patient had adult Still's disease.
  
  
  CONCLUSIONS
  This case shows how the presentation and symptom complex of Still's disease together with the lack of specific serological markers can misguide the diagnosis.
authors: Department of Anesthesiology, University of Virginia, Charlottesville, VA.
authors: Sandeep
authors: S
authors: Yerra
authors: Internal Medicine, Wake Forest Baptist Health, Winston-Salem.
authors: Letlhogonolo
authors: L
authors: Tlhabano
authors: Internal Medicine, East Carolina University, Greenville, NC, USA.
authors: Tejaswini
authors: T
authors: Vasamsetty
keywords: adult Still’s disease; hemophagocytic lymphohistiocytosis; immunology; rheumatology