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Fever of unknown origin

Prabahs Prasun Giri, Joydeb Roy, Agnisekhar Saha
Aim of the Study: Scrub typhus has been globally recognized as an emerging infectious disease contributing significantly to pyrexia of unknown origin (PUO) and a potential cause of multiorgan dysfunction syndrome (MODS). We studied the incidence of scrub typhus as a cause of pediatric intensive care unit (PICU) admission and MODS in our hospital and its clinical and laboratory characteristics to measure the incidence of MODS caused by scrub typhus. Materials and Methods: This study was done in a pediatric teaching hospital in Kolkata, India...
February 2018: Indian Journal of Critical Care Medicine
Y Zhang, X J Zeng
No abstract text is available yet for this article.
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Chamara Dalugama, Indika Bandara Gawarammana
BACKGROUND: Tuberculosis is a major health problem in the developing world. Diagnosis of extrapulmonary tuberculosis is delayed because the presentation is nonspecific. Extrapulmonary tuberculosis can present with various hematological manifestations, including pancytopenia. Pancytopenia could be due to hypersplenism, maturation arrest, hemophagocytic lymphohistiocytosis, or infiltration of the bone marrow by caseating or noncaseating granulomas causing reversible or irreversible fibrosis...
March 6, 2018: Journal of Medical Case Reports
Mikhail M Kostik, Evgeny N Suspitsin, Marina N Guseva, Anastasia S Levina, Anastasia Y Kazantseva, Anna P Sokolenko, Evgeny N Imyanitov
NLRP12-related autoinflammatory disease (NLRP12-AID) is an exceptionally rare autosomal dominant disorder caused by germline mutations in NLRP12 gene. Very few patients with NLRP12-AD have been identified worldwide; therefore, there is a scarcity of data on phenotypic presentation of this syndrome. Here we provide evidence that NLRP12-AID may have clinical manifestations characteristic for primary immune deficiencies (PID). 246 children with periodic fever (PF) of unknown origin were subjects to the next generation sequencing (NGS) analysis; 213 of these patients had signs of primary immunodeficiency (PID) manifested by recurrent infections, while 33 kids had isolated PF...
March 2, 2018: Rheumatology International
Maria Zerkaoui, Fatima Zahra Laarabi, Yousra Ajhoun, Bouchra Chkirate, Abdelaziz Sefiani
BACKGROUND: Familial Mediterranean fever is an autoinflammatory disease of unknown etiology, characterized clinically by recurrent attacks of sudden-onset fever with arthralgia and/or thoracoabdominal pain and pathogenetically by autosomal recessive inheritance due to a mutation in the MEFV gene. Behçet's disease is an inflammatory disease characterized by recurrent oral and genital aphthous ulcerations, uveitis, and skin lesions. Preliminarily, our literature review suggested that patients with familial Mediterranean fever who also have Behçet's disease have only a single mutated familial Mediterranean fever gene...
March 1, 2018: Journal of Medical Case Reports
James W Antoon, David C Peritz, Michael R Parsons, Asheley C Skinner, Jacob A Lohr
BACKGROUND: Fever of unknown origin (FUO) is a well-known pediatric presentation. The primary studies determining the causes of prolonged fever in children were performed 4 decades ago, before major advances in laboratory and diagnostic testing. Given that the distribution of diagnosed causes of adult FUO has changed in recent decades, we hypothesized that the etiology of FUO in children has concordantly changed and also may be impacted by a definition that includes a shorter required duration of fever...
March 2018: Hospital Pediatrics
Yeter Düzenli Kar, Zeynep Canan Özdemir, Özcan Bör
Aim: Febrile neutropenia is an important cause of mortality and morbidity in hematology-oncology patients undergoing chemotherapy. The objective of this study was to evaluate febrile neutropenic episodes in children with malignancy. Material and Methods: Sixty-eight children who received chemotherapy for malignancy between 2010 and 2015 were retrospectively reviewed. The demographic characteristics, laboratory data, infection foci, and frequency of microorganisms grown in culture were examined...
December 2017: Türk Pediatri Arşivi
Chamara Dalugama
BACKGROUND: Pyrexia of unknown origin is a difficult and challenging problem for the physician. Endocrine disorders, such as subacute thyroiditis, rarely present with pyrexia of unknown origin. Subacute thyroiditis can have a broad spectrum of clinical presentations including fever and biochemical thyrotoxicosis without overt signs or symptoms. CASE PRESENTATION: A previously healthy 42-year-old Sri Lankan Sinhalese man was extensively investigated for a prolonged fever of 3 weeks with high inflammatory markers...
February 23, 2018: Journal of Medical Case Reports
Tharsika Kuganesan, Allen R Huang
BACKGROUND: Giant cell arteritis (GCA) is an immune mediated inflammatory disease of medium and large arteries which afflicts older people. The classical presentation features include: headache, visual disturbances, and jaw claudication. Patients diagnosed with GCA have also been observed to be at higher risk for the subsequent development of strokes. CASE PRESENTATION: We describe a case of an 84-year old right-handed man who presented to hospital with dysarthria, dysphagia, right-sided facial drop, a history of generalized weakness and multiple falls...
February 21, 2018: BMC Geriatrics
YongXiang Tang, HongPei Tan, Shuo Hu
FDG PET/CT was performed in a 30-year-old woman to detect the source of fever of unknown origin. The images showed widespread abnormal activity, consistent with lymphoma. However, lymph node biopsy revealed only inflammation, and a diagnosis of familial hemophagocytic lymphohistiocytosis was eventually made after familial hemophagocytic lymphohistiocytosis-specific gene was detected. After proper therapy, a follow-up FDG PET/CT examination 2 months later showed resolution of most of the previously seen lesions...
February 21, 2018: Clinical Nuclear Medicine
Pierre Alex Crisinel
Persistent fever or FUO (fever of unknown origin) is defined by a fever of more than 1‑2 weeks that remains unexplained, after considerable diagnostic efforts. In the travelling child, in addition to cosmopolitan infectious diseases, tropical pathogens must absolutely be considered according to the regions visited and the activities practiced. A detailed history and a complete clinical examination are essential to decide which supplementary investigations will complete the basic assessment, which must contain the search for malaria in any child who has visited an endemic area...
February 14, 2018: Revue Médicale Suisse
Ilse J E Kouijzer, Catharina M Mulders-Manders, Chantal P Bleeker-Rovers, Wim J G Oyen
Fever of unknown origin (FUO) is commonly defined as fever higher than 38.3°C on several occasions during at least 3 weeks with uncertain diagnosis after a number of obligatory investigations. The differential diagnosis of FUO can be subdivided in four categories: infections, malignancies, noninfectious inflammatory diseases, and miscellaneous causes. In most cases of FUO, there is an uncommon presentation of a common disease. FDG-PET/CT is a sensitive diagnostic technique for the evaluation of FUO by facilitating anatomical localization of focally increased FDG uptake, thereby guiding further diagnostic tests to achieve a final diagnosis...
March 2018: Seminars in Nuclear Medicine
Lenaïg Le Clech, Jean-Philippe Talarmin, Marie-Anne Couturier, Jean-Christophe Ianotto, Christophe Nicol, Ronan Le Calloch, Stéphanie Dos Santos, Pascal Hutin, Didier Tandé, Virginie Cogulet, Christian Berthou, Gaëlle Guillerm
INTRODUCTION: Immediate empirical antibiotic therapy is mandatory in febrile chemotherapy-induced neutropenia, but its optimal duration is unclear, especially in patients with fever of unknown origin (FUO). OBJECTIVES: The primary objective of this 20-month prospective observational study was to evaluate the feasibility and safety of short-term antibiotic treatment in afebrile or febrile patients exhibiting FUO, irrespective of their neutrophil count. The secondary objective was to describe the epidemiology of all episodes of febrile neutropenia...
February 16, 2018: Infectious Diseases
Priyanka Verma, Ramesh V Asopa
Human immunodeficiency virus (HIV)-related dementia is the most severe form of neurocognitive disorder in patients with AIDS. It is relatively uncommon in postantiretroviral therapy (HAART) era and is associated with a high cerebrospinal fluid CSF/plasma viral load. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has proven useful in malignancies, infections, and central nervous system lesions in HIV-infected patients and has been used to explore regional cerebral glucose metabolism patterns in HIV-positive patients with and without cognitive impairment...
January 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Alfonso Campanile, Guido Tavazzi, Francesco Caprioglio, Fausto Rigo
BACKGROUND: Infective endocarditis (IE) is still a condition with high mortality and morbidity, especially in the elderly, and in patients with prosthetic valves. The concept of "time-to-therapy" plays a key role for the prompt management of IE and related complications, and the currently available multimodality imaging may play a key role in this setting. Myocardial ischemia due to extrinsic coronary compression from an aortic abscess is an extremely rare condition where the optimal therapeutic strategy has not been defined yet...
February 9, 2018: BMC Cardiovascular Disorders
Caitlin Butler, William Paul Skelton, Arpan Patel, Dhruv Mahtta, Yi Zhuang, Kartik Cherabuddi, Kairav Shah, Merry Markham
A 52-year-old man presented to our hospital for further workup of fever of unknown origin after an extensive workup at an outside hospital had failed to reveal a diagnosis. At the outside hospital, he underwent excisional biopsy of the left supraclavicular lymph node, which showed non-necrotising granulomatous changes, and a bone marrow biopsy which showed a normocellular marrow. He was discharged without a diagnosis with recommendations to present to a tertiary hospital. During his admission, his hospital course was complicated by new direct hyperbilirubinaemia and eosinophilia, prompting liver and skin biopsies which showed CD30+ and CD3+ cells...
February 2, 2018: BMJ Case Reports
Burke A Cunha, Bertamaria Dieguez, Alena Varantsova
Culture negative endocarditis (CNE) is a common concern in patients with fever, heart murmur, cardiac vegetation, and negative blood cultures. The diagnosis of CNE is not based only on negative blood cultures and a cardiac vegetation. The clinical definition of CNE is based on negative blood cultures plus the findings of culture positive infective endocarditis (IE), e.g., fever, cardiac vegetation, splenomegaly, peripheral manifestations. Because embolic splenic infarcts may occur with culture positive IE, some may assume that splenic infarcts are a sign of CNE...
February 7, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Lukas Frans Ocias, Bo Bødker Jensen, Steen Villumsen, Anne-Mette Lebech, Sigurdur Skarphedinsson, Ram Benny Dessau, Karen Angeliki Krogfelt
Rickettsia spp. can be found across the globe and cause disease of varying clinical severity, ranging from life-threatening infections with widespread vasculitis to milder, more localized presentations. Vector and, to some degree, reservoir are hematophagous arthropods, with most species harboured by ticks. In Denmark, rickettsiae are known as a cause of imported travel-related infections, but are also found endemically in ticks across the country. Data are, however, lacking on the geographical origin and clinical features of diagnosed cases...
February 1, 2018: Ticks and Tick-borne Diseases
Soo-Youn Moon, Ki-Ho Park, Mi Suk Lee, Jun Seong Son
BACKGROUND: Traditional Oriental medicine is used in many Asian countries and involves herbal medicines, acupuncture, moxibustion, and cupping. We investigated the incidence and causes of hospital-acquired fever (HAF) and the characteristics of febrile inpatients in Oriental medical hospitals (OMHs). METHODS: Patients hospitalized in two OMHs of a university medical institute in Seoul, Korea, were retrospectively reviewed from 2006 to 2013. Adult patients with HAF were enrolled...
February 7, 2018: BMC Health Services Research
Thatchai Kampitak
No abstract text is available yet for this article.
February 3, 2018: Travel Medicine and Infectious Disease
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