THE CASE
An 18-year-old, immune-deficient young man presents to his immunologist's office with a
1-day history of dysuria. He has common variable immunodeficiency disease (CVID) complicated by bronchiectasis and a number of autoimmune processes, including type 1 diabetes for which he is currently on an insulin pump; Evans syndrome for which he has had a splenectomy; autoimmune hepatitis; and lymphocytic colitis. He reveals that he recently had unprotected sexual intercourse with a new male partner while vacationing in Florida the week prior to this presentation. He also thinks he may have been dehydrated while on vacation.