- Case Challenge: A Mysterious Case of Muscle Pain.Presentation. A 45-year-old man presents with a three-week history of severe muscle pain and intermittent fevers. Initially, the pain was generalized, but over the past few days, it has become so intense that even turning in bed is excruciating. He now reports that moving his tongue is painful, making it difficult to eat and speak.… Read more: Case Challenge: A Mysterious Case of Muscle Pain.