A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever. The patient’s current medications include atorvastat

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Scenario: 

• A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever.
• The patient’s current medications include atorvastatin 40 mg at night, methotrexate 10 mg po every Friday morning, and prednisone 5 mg po qam.
• He states that he has had a fever up to 101 degrees F for about a week and admits to chills and sweats.
• He says he has had more fatigue than usual and reports some chest pain associated with coughing.
• He admits to having occasional episodes of hemoptysis.
• He works as a grain inspector at a large farm cooperative.
• After extensive work-up, the patient was diagnosed with Invasive aspergillosis.

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