Dr. Harry Oken is a solo Internal Medicine practitioner and a Professor at the University of Maryland. He served for 14 years as Chairman of Medicine at Howard County General Hospital, where he is currently on staff as an Attending Physician. He was recently named a “Top Doc” in Baltimore Magazine.

Here, Dr. Oken presents the case of a middle-aged patient with a history of depression and hypothyroidism who had unusual symptoms, including one-sided allodynia, “pins and needles” sensation, headaches, joint pain, periodic night sweats and IBS symptoms. Treatments included a therapeutic trial of steroids, which caused a steroid psychosis and led to inpatient psychiatric hospitalization, culminating in 50+ Electroconvulsive treatments. A blood culture was positive for an atypical Mycobacteria and a three drug antibiotic regimen was begun with dramatic sustained improvement.