My 17 yo son was admitted to hospital last week with fever to 103 for 3 days, severe midline back pain, headache, and brown iced tea colored urine. He had no source of fever ID d. PE did not show any tenderness, no swelling, no rashes, or other focal abnormalities. He has adrenal insufficiency, growth hormone deficiency, beta thallesemia minor, pseudotumor cerebri x waxing and waning for several years. They did MRI of head and spine, LP, labs, ua, flu, mono. Only positive results were elevated bilirubin, and a hgb of 7, and his stool was heme positive. They presumed he might have a virus, might have myositis causing back pain, and these may have caused hemolysis. He received 8 liters of fluid over 2.5 days, toradol, Tylenol, and finally over 24 hours later to address his pain. He has been home for 4 days now, and he continues to run low grade temp, 99.4 to 100. His back pain is better, but now he is having terrible pain in his ankles, his appetite is poor, and he has lost over 8 pounds in a week. He has finished his stress dosing of Prednisone (3 days upon DC), and is on his usual meds of Diamox, cortef, zyrtec, singulair. They started him on protonix. He was started on Zoloft about 8 weeks ago. I don t feel like we have any answers, as he is not improving. Where do I go from here?