• David Lagier, Marine Gaudry, Hubert Lepidi, Cindy Perron, and Catherine Guidon.
• Department of Cardiovascular Critical Care Medicine, University Hospital La Timone, Aix-Marseille University, Marseille, France. Electronic address: david.lagier@ap-hm.fr.
• Chest. 2018 Oct 1; 154 (4): e107-e111.

Case PresentationA 62-year-old woman with no medical history was admitted to the ED for fever, acute respiratory failure, and pain in the right lower limb. Three months prior to presentation, she had spent 45 days travelling through India and Thailand. She presented with no signs of traveler's disease such as fever or diarrhea during that trip. Two weeks following her return to France, the patient presented with an episode of bronchitis and received 5 days of treatment with cefixime (a third-generation cephalosporin). Despite this antibiotic treatment, her symptoms worsened and she developed, over the following 3 weeks, general weakness and arthralgia/myalgia. Due to the severity of hypoxemia, the patient was immediately transferred to the ICU.Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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