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A young woman with fever and low back pain

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  • 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.