Article Text
Image challenge
A young woman with fever and low back pain
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Footnotes
Collaborators Dr Shirakwa, Dr Hagiwara and Dr Okuyama contributed to patient management.
Contributors All authors contributed to patient management. YS drafted the initial manuscript. All authors contributed to writing the manuscript. All the authors have provided written consent for publication.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The Institutional Review Board at JR Tokyo General Hospital.
Provenance and peer review Not commissioned; internally peer reviewed.