Age: 25.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Fatigue, Generalised oedema, Impaired driving ability, Joint swelling, Laboratory test abnormal
Clinical narrative: August ? October 2021 ? 2 to 3 incidents of lip swelling (never had reactions like this in my life, assumed allergic to some food) 4 November 2021 ?   28 January 2022 ? Covid Vaccine Booster Shot #3, Lot# F26369,    19 March 2022- First recorded incident of lips and eyes swelling (photo) 14 April 2022 ? first photo record of blisters (torso and arms), migratory joint pain/swelling (fingers, elbows, shoulders, hips, knees, feet) and new blisters ? 4 to 5 times a week 06 June 2022 ? Short Flight Physical ? Downslip for eye swelling ? until TBD 14 June 2022 ? initial appointment with Allergy doctor at Medical Center (conducted allergy blood test) ? results no allergies. 11-12 July 2022 ? walk-in appointment with Rheumatology at Facility, full lab workup 15 July 2022 ? notified tested positive for the quantiFERON Gold test (tested positive for Tuberculosis)  18 July 2022 ? Chest XRAY at Facility 22 July 2022 ? Diagnosed with BSLE (Bullous Systemic Lupus Erythematosus) 27 July 2022 ? Diagnosed with Latent Tuberculosis (LTB) 27 July 2022 ? Started Isoniazid (TB treatment) 28 July 2022 ? Started Dapsone for BSLE ( 2-3 days noticed significant improvement in symptoms)  31 August 2022 ?  reported at work on 25 September 2022 (symptoms remained 4-5 times a week, arthritic joints, swelling/pain) 24 October 2022 ? Referral appointment to Facility 29 October 2022 ? Started Plaquenil 29/30 November ? Rash on feet began to develop  2/3 December 2022 ? Major flare across entire body, significant pain, swelling, fatigue (shoulders, elbows, hands, knees, hips, feet) unable to raise arms above chest ? unable to complete routine tasks) 05 December 2022 ? Second appointment at Facility (discussed starting methotrexate) ? had rash on feet 09 December 2022 ? Stopped Isoniazid due to increasing severity of rash on feet and developing rash on body  09 December ? Started prednisone  05-06 January 2023 ? In-person consultation with Medical Center with Rheumatology, Dermatology, and Infectious Disease. 27 January 2023 ? Facility Fellow Dr. assumed medical care through Facility as proxy 23 February 2023 ? first recorded chest pain. Sharp pain when lifting 2yo up, dropped to one knee with 3 to 4 sharp pains lasting 8-15 seconds 24 February 2023 ? 0947 Driving, felt like a bubble moving then popping (producing sharp pain) Pulled over and sat for few minutes.    -1642 Ache in center point of chest lasted 5-7 min   -significant fatigue 25 February 2023 ? migratory swelling/arthritic (left hand, left elbow, right knee) 26 February 2023 ? Swelling reduced 27 February 2023 ?  0958 left knee arthritic/ swelling - 1723 Chest pressure/discomfort  - 1852 Chest discomfort sitting on couch  - 1940 left ring finger swollen - 2233 Chest discomfort, rising pang on left side 28 February 2023 ? 0818 all joints better / significant fatigue - 1259 chest discomfort  (pressure left peck) - 1606 sitting on couch, weight on chest/ uncomfortable pressure - 2046 Malaise feeling in chest / not painful but not comfortable (distant pressure?) 1 March 2023 ? 0827 Sharp pain right chest with breath in   -0849 sharp pain/discomfort at the top of breath right chest   -1715 pressure/discomfort on back (opposite of left peck) 2 March 2023 ? 1208  left shoulder pain, forearm pain (concerned heart related) 3 March 2023 ? 1155 Chest pain/pressure, left are bicep/elbow pain   Noted on and off chest pain daily, occasionally sharp pain, almost always left chest) 3 March 2023 ? went to Medical Center Emergency Room for continued chest pain  1 EKG: normal, discharged with no further testing  Went to Health Emergency Room   3 EKGs all normal, chest xray normal, CT w/contrast normal 10 April 2023 ? Started methotrexate 17 May 2023 ? Echocardiogram. CT Scan   List of Reoccurring Symptoms: -Brain fog (worst event, forgot name and introduction) -migratory arthritic joint pain (worst event, could not lift arms above chest ? could not complete routine tasks) -blisters on the torso, arms, and legs -extreme fatigue  -Malaise  -Chest pain