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https://www.readbyqxmd.com/read/28811951/granulomatosis-with-polyangiitis-presenting-as-pyrexia-of-unknown-origin-leukocytosis-and-microangiopathic-haemolytic-anemia
#1
Sima Terebelo, Iona Chen
A 66-year-old woman presented to the Emergency Department with a florid sepsis-like picture, a two-week history of fever, relative hypotension with end organ ischemia (unexplained liver enzyme and troponin elevations), and nonspecific constitutional symptoms. She was initially found to have a urinary tract infection but, despite appropriate treatment, her fever persisted and her white blood cell count continued to rise. During her hospitalization the patient manifested leukocytosis to 47,000 WBC/μL, ESR 67 mm/hr (normal range 0-42 mm/hr), CRP 17...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28810044/swept-source-optical-coherence-tomography-angiography-in-west-nile-virus-chorioretinitis-and-associated-occlusive-retinal-vasculitis
#2
Moncef Khairallah, Rim Kahloun, Salma Gargouri, Bechir Jelliti, Dorra Sellami, Salim Ben Yahia, Jamel Feki
A 65-year-old man with diabetes and a history of fever of unknown origin 2 weeks earlier complained of sudden decreased vision in the left eye. The patient was diagnosed with bilateral West Nile virus (WNV) chorioretinitis associated with occlusive retinal vasculitis in the left eye. Swept-source optical coherence tomography angiography (SS-OCTA) of the left eye showed extensive, well-delineated, hypointense non-perfusion areas and perifoveal capillary arcade disruption in the superficial capillary plexus, as well as larger non-perfusion areas, capillary rarefaction, and diffuse capillary network attenuation and disorganization in the deep capillary plexus...
August 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28806242/generalized-lymph-node-fdg-uptake-as-the-first-manifestation-of-systemic-lupus-erythematosus
#3
Antoine Girard, Jessica Ohnona, Jean-François Bernaudin, Françoise Montravers, Claude Bachmeyer
We report 2 cases of young patients referred for FDG PET/CT for peripheral lymphadenopathy and moderate fever associated with pericarditis in 1 patient and glomerulonephritis in the other patient. FDG PET/CT showed a very similar appearance in these 2 patients, with highly avid lymph nodes with axillary predominance and diffuse FDG uptake in spleen and bone marrow. Systemic lupus erythematosus with an unusual presentation of generalized lymphadenopathy was diagnosed in both patients. This FDG distribution pattern should be kept in mind when PET is performed for etiological investigation of fever of unknown origin...
August 12, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28782120/cases-of-transfusion-transmitted-babesiosis-occurring-in-nonendemic-areas-a-diagnostic-dilemma
#4
David P LeBel, Erin D Moritz, Jennifer J O'Brien, John Lazarchick, Lee Marie Tormos, Angie Duong, Magali J Fontaine, Jerry E Squires, Susan L Stramer
BACKGROUND: Transfusion-transmitted babesiosis (TTB) has been rapidly increasing in incidence since the beginning of the 21st century. Asymptomatic individuals with Babesia infection are able to donate blood in the United States because of the lack of specific blood donation testing. Blood products collected in Babesia-endemic areas are distributed nationally; thus, clinicians in nonendemic states may fail to include babesiosis in the differential diagnosis of a patient who had a recent transfusion history and a fever of unknown origin...
August 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28768449/recurrent-fuo-due-to-intermittent-enterobacter-cloacae-bacteremias-from-an-infected-pacemaker-lead-diagnosed-by-gallium-scan
#5
Burke A Cunha, Ismail Jimada
Fever of unknown origin (FUO) refers to fevers of ≥101° F that persist for ≥3 weeks and remain undiagnosed after a focused inpatient or outpatient workup. FUO may be due to infectious, malignant/neoplastic, rheumatic/inflammatory, or miscellaneous disorders. Recurrent FUOs are due to the same causes of classical FUOs. Recurrent FUOs may have continuous or intermittent fevers and are particularly difficult to diagnose. With intermittent fever, recurrent FUO diagnostic tests are best obtained during fever episodes...
August 2, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28767581/diagnostic-value-of-pet-ct-for-giant-cell-arteritis-combined-with-pulmonary-embolism-presenting-case-report-and-literature-review
#6
Xiaoming Shu, Xiaoxiang Xu, Qinglin Peng, Xin Lu, Li Ma, Na Mi, Guochun Wang
RATIONALE: Giant cell arteritis (GCA) combined with concomitant pulmonary embolism (PE) is extremely difficult to diagnose because of its low incidence and atypical clinical presentations. PATIENT CONCERNS: A 62-year-old male developed fever of unknown origin. DIAGNOSES: Positron emission tomography/computed tomography (PET/CT) revealed increased glucose metabolism in the vascular walls of the ascending and descending aorta and pulmonary artery, leading to a diagnosis of GCA combined with PE...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28764157/seroepidemiology-of-spotted-fever-rickettsiosis-in-uttar-pradesh-a-prospective-study
#7
Chandra Dev Pati Tripathi, Mastan Singh, Jyotsna Agarwal, Chandra Kanta, Virendra Atam
INTRODUCTION: Spotted Fever Rickettsiosis (SFR), an acute febrile illness caused by Rickettsia rickettsii, R. conorii and R. akari which is associated with considerable morbidity and mortality. SFR is one of the most covert emerging infections of the present time which is prevalent in various parts of India as shown by the increase in the number of clinically diagnosed patients in various states except Uttar Pradesh. AIM: To diagnose SFR in clinically suspected patients using serological tests and recognition of common epidemiologic situations and clinical manifestations of SFR in the state of Uttar Pradesh...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763426/epidemiology-of-sepsis-like-illness-in-young-infants-major-role-of-enterovirus-and-human-parechovirus
#8
Eveline P de Jong, Monique G A van den Beuken, Erika P M van Elzakker, K C Wolthers, Arwen J Sprij, E Lopriore, Frans J Walther, Frank Brus
BACKGROUND: Sepsis-like illness is a main cause for hospital admission in young infants. Our aim was to investigate incidence, epidemiology and clinical characteristics of enterovirus (EV) and human parechovirus (HPeV) infections in young infants with sepsis-like illness. METHODS: This is a prospective observational cohort study in which infants younger than 90 days of age, presenting with sepsis-like symptoms in a secondary care children's hospital, underwent a full sepsis work-up...
July 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28756023/febrile-rhabdomyolysis-of-unknown-origin-in-refugees-coming-from-west-africa-through-the-mediterranean
#9
Silvia Odolini, Federico Gobbi, Lorenzo Zammarchi, Simona Migliore, Paola Mencarini, Marco Vecchia, Nicoletta di Lauria, Simona Schivazappa, Tony Sabatini, Leonardo Chianura, Elisa Vanino, Daniela Piacentini, Paola Zanotti, Anna Bussi, Alessandro Bartoloni, Zeno Bisoffi, Francesco Castelli
OBJECTIVES: Cases of undiagnosed severe febrile rhabdomyolysis in refugees coming from West Africa, mainly from Nigeria, has been observed since May 2014. The aim of this study was to describe this phenomenon. METHODS: This was a multicentre retrospective observational study of cases of febrile rhabdomyolysis reported from May 2014 to December 2016 in 12 Italian centres. RESULTS: A total of 48 cases were observed, mainly in young males. The mean time interval between the day of departure from Libya and symptom onset was 26...
July 26, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28752149/systemic-juvenile-idiopathic-arthritis-as-a-fever-of-unknown-origin
#10
Cigdem Hardal, Muferet Erguven, Zuhal Aydan Saglam
Juvenile idiopathic arthritis (JIA) is a rare inflammation with still unidentified cause. It can also be cause of fever of unknown origin. Diagnosis is made by eliminating infection, malignancy, and rheumatological diseases. In this report, case of a 5-year-old patient with symptoms of intermittent fever, areas of rash on the body, itching, and swelling, redness, and pain in the right and left ankle is described. Serological test results were negative for infectious agents, and malignancy was excluded. Patient was diagnosed with systemic JIA associated with intermittent fever, negative rheumatological markers and negative serology test results...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28747170/spatial-prediction-and-validation-of-zoonotic-hazard-through-micro-habitat-properties-where-does-puumala-hantavirus-hole-up
#11
Hussein Khalil, Gert Olsson, Magnus Magnusson, Magnus Evander, Birger Hörnfeldt, Frauke Ecke
BACKGROUND: To predict the risk of infectious diseases originating in wildlife, it is important to identify habitats that allow the co-occurrence of pathogens and their hosts. Puumala hantavirus (PUUV) is a directly-transmitted RNA virus that causes hemorrhagic fever in humans, and is carried and transmitted by the bank vole (Myodes glareolus). In northern Sweden, bank voles undergo 3-4 year population cycles, during which their spatial distribution varies greatly. METHODS: We used boosted regression trees; a technique inspired by machine learning, on a 10 - year time-series (fall 2003-2013) to develop a spatial predictive model assessing seasonal PUUV hazard using micro-habitat variables in a landscape heavily modified by forestry...
July 26, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28746194/18f-fdg-pet-ct-is-an-ideal-imaging-modality-for-the-early-diagnosis-of-relapsing-polychondritis-a-case-report
#12
JianJie Wang, XiaoFei Liu, Chaoyu Pu, Yan Chen
BACKGROUND: Relapsing polychondritis (RP) is a rare autoimmune disease of unknown etiology that may affect multiple cartilage throughout the body. CASE REPORT: We report on a middle-aged man presented with cough, chest tightness, and fever of unknown origin, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) was performed. And the imaging shows multiple increased FDG accumulation in tracheobronchial tree and all intercostal cartilages, as well as in nasal, right auricule, laryngeal cartilage...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28737201/-paniculitis-as-manifestation-of-prolonged-febrile-syndrome-case-report
#13
Alexa Puchi Silva, Paulina López Radrigán, Montserrat Zapico Lafuente, Sergio Tapia Carrere, Sergio González Bombardiere
Fever of unknown origin (FUO) is defined as fever over 7 to 10 days without a diagnosis despite a complete initial study. The most frequent causes are infections, autoimmune and tumors. Even though most cases are self-limited there is a minority that has an underlying etiology with an ominous forecast, encouraging a systematized study. OBJECTIVE: To report a rare case of a boy who presented fever of unknown origin associated to panniculitis and was diagnosed of subcutaneous panniculitis-like-T cell lymphoma and to emphasis the importance of a sequential study of FUO, in order to reach a diagnosis in patients who need a timely intervention...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28737147/brucella-causing-liver-abscess-in-a-child-with-selective-iga-deficiency
#14
Devdeep Mukherjee, Priyankar Pal, Ritabrata Kundu
BACKGROUND: Brucella has been known to cause pyrexia of unknown origin. CASE CHARACTERISTICS: 9-year-old boy with fever and abdominal pain; multiple abscesses within the liver on ultrasonography. OBSERVATIONS: IgM Antibodies against Brucella were raised in his serum sample, and Brucella serum agglutination test was positive. Immunological work-up suggested selective IgA deficiency. Reduction in size following treatment with trimethoprim-sulphamethoxazole, amikacin and doxycycline...
July 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28726033/recommendations-for-the-inclusion-of-fabry-disease-as-a-rare-febrile-condition-in-existing-algorithms-for-fever-of-unknown-origin
#15
Raffaele Manna, Roberto Cauda, Sandro Feriozzi, Giovanni Gambaro, Antonio Gasbarrini, Didier Lacombe, Avi Livneh, Alberto Martini, Huri Ozdogan, Antonio Pisani, Eleonora Riccio, Elena Verrecchia, Lorenzo Dagna
Fever of unknown origin (FUO) is a rather rare clinical syndrome representing a major diagnostic challenge. The occurrence of more than three febrile attacks with fever-free intervals of variable duration during 6 months of observation has recently been proposed as a subcategory of FUO, Recurrent FUO (RFUO). A substantial number of patients with RFUO have auto-inflammatory genetic fevers, but many patients remain undiagnosed. We hypothesize that this undiagnosed subgroup may be comprised of, at least in part, a number of rare genetic febrile diseases such as Fabry disease...
July 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28720215/autoimmune-meningitis-and-encephalitis-in-adult-onset-still-disease-case-report
#16
Bożek Milena, Konopko Magdalena, Wierzba-Bobrowicz Teresa, Witkowski Grzegorz, Makowicz Grzegorz, Sienkiewicz-Jarosz Halina
INTRODUCTION: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown cause. Its symptoms usually include persistent fever, fugitive salmon-colored rash, arthritis, sore throat (not specific), but it may also lead to internal organs' involvement, which presents with enlargement of the liver and spleen, swollen lymph nodes, carditis or pleuritis - potentially life-threatening complications. In rare cases, AOSD can cause aseptic meningitis or/and encephalitis...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28711429/-appropriateness-of-antibiotic-prescribing-in-paediatric-patients-in-a-hospital-emergency-department
#17
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28685493/peripheral-neuropathy-episodic-rhabdomyolysis-and-hypoparathyroidism-in-a-patient-with-mitochondrial-trifunctional-protein-deficiency
#18
Peter van Vliet, Annelies E Berden, Mojca K M van Schie, Jaap A Bakker, Christian Heringhaus, Irenaeus F M de Coo, Mirjam Langeveld, Marielle A Schroijen, M Sesmu Arbous
A combination of unexplained peripheral neuropathy, hypoparathyroidism, and the inability to cope with metabolic stress could point to a rare inborn error of metabolism, such as mitochondrial trifunctional protein (MTP) deficiency.Here, we describe a 20-year-old woman who was known since childhood with axonal motor sensory polyneuropathy of unknown origin. She presented with progressive dyspnoea, and increased muscle weakness, preceded by 6 days of fever, vomiting, and diarrhoea. Laboratory testing showed rhabdomyolysis, and hypocalcaemia with low parathyroid levels...
July 7, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28680225/type-2-lepra-reaction-presenting-as-fever-of-unknown-origin-identified-on-18-f-fluoro-2-deoxyglucose-positron-emission-tomography-computed-tomography
#19
Piyush Chandra, Satish Nath, Srinivas Chakravarthy, Jemima Kingsley
No abstract text is available yet for this article.
July 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28672419/-autoinflammatory-diseases-as-a-differential-diagnosis-of%C3%A2-fever%C3%A2-of-unknown-origin
#20
REVIEW
Jasmin Beate Kümmerle-Deschner
Fever is the most leading symptom of autoinflammatory diseases (AID). Therefore, AID have to be considered in differential diagnosis concerning fever of unknown origin. Unspecific Inflammatory manifestations may lead to misinterpretations that possibly cause irreversible organ damage. Effective treatment options are available and imply profound diagnostics.
July 2017: Deutsche Medizinische Wochenschrift
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