Nailing the Diagnosis—Antisynthetase Syndrome as a Cause for Pyrexia of Unknown Origin

A 67-year old Hainanese homemaker with a past medical history of hypertension presented with a 2-month history of quotidian fever of 38°-39°C associated with a truncal maculopapular rash (Figure 1). She did not have significant contact or travel history. She discharged against medical advice due to cost issues after a 3-day admission. She re-presented a month later with persistent fever and a 1-week history of productive cough associated with symptoms of fluid overload. The rash had resolved by this time.