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fever unknown origin

Ahmed Zaghloul, Corina Iorgoveanu, Andrew Polio, Aakash Desai
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is an extremely rare, self-limiting disorder which typically presents with fever and painful, unilateral cervical lymphadenopathy in previously healthy individuals. Here, we describe a case of KFD which initially presented with fever of unknown origin. Due to its non-specific symptoms and low incidence, KFD poses a diagnostic conundrum for clinicians. Awareness of this disease entity is the key for prompt diagnosis and treatment...
April 19, 2018: Curēus
Catharina M Mulders-Manders, Celeste Engwerda, Anna Simon, Jos W M van der Meer, Chantal P Bleeker-Rovers
In 30-50% of patients with fever of unknown origin (IUO) no explanation for the fever can be found. Prognosis and effects of empirical treatment of these patients are largely unknown.With this retrospective, questionnaire based corort study in all unexplained FUO patients in an expert center between 2003 and 2014 we studied mortality and outcome.In 131 of 274 FUO patients, FUO remained unexplained. Ninety-nine of them responded to the long-term follow up questionnaire. Adter a median duration of follow-up of 60 months, spontaneous remission of fever occured in 47...
June 2018: Medicine (Baltimore)
Liat Shargian-Alon, Ronit Gurion, Pia Raanani, Dafna Yahav, Anat Gafter-Gvili
BACKGROUND: The reported data regarding the effects of hypomethylating agents (HMAs) on the risk of infections seem to be poorly documented and heterogeneous. We conducted a systematic review and meta-analysis of all randomized controlled trials comparing HMA-containing regimens with any other regimen administered to patients with myeloid neoplasms. MATERIALS AND METHODS: A comprehensive search was conducted until February 2018. Two reviewers appraised the quality of the trials and the extracted data...
May 28, 2018: Clinical Lymphoma, Myeloma & Leukemia
Morgan Burke, Melissa Hardesty, Wayne Downs
Recurrent clear cell ovarian carcinoma is a difficult to treat condition and early trial data has suggested a possible role for immune checkpoint inhibitors. Nivolumab is an anti-PD-1 immunotherapy that has been used in this setting. While immune related toxicity of these agents has been well described, the occurrence of immune specific neurotoxicity is thought to be rare. We present a case of severe encephalitis while on PD-1 immunotherapy for a recurrent ovarian clear cell cancer and we believe this to be the first such reported case associated with the use of PD-1 inhibitor monotherapy...
May 2018: Gynecologic Oncology Reports
Noémie Boillat-Blanco, Zainab Mbarack, Josephine Samaka, Tarsis Mlaganile, Aline Mamin, Blaise Genton, Laurent Kaiser, Thierry Calandra, Valérie D'Acremont
BACKGROUND: Quick Sequential Organ Failure Assessment (qSOFA) is a three-item clinical instrument for bedside identification of sepsis patients at risk of poor outcome. qSOFA could be a valuable triage tool in emergency departments of low-income countries, yet its performance in resource-limited settings remains unknown. The prognostic accuracy of qSOFA for 28-day all-cause mortality in febrile adults treated at the EDs in a low-income country was evaluated. METHODS: Retrospective analysis of a prospective cohort study of consecutive patients (≥18 years) with fever (tympanic temperature ≥38°C and fever ≤7 days) who presented between July 2013 and May 2014 at four emergency departments in Dar es Salaam, Tanzania...
2018: PloS One
Yong-Zhi Zhai, Xin Chen, Xin Liu, Zhi-Qiang Zhang, Hong-Ju Xiao, Gang Liu
Fever of unknown origin (FUO) is a frequently observed phenomenon in clinical practice. The present study was aimed to investigate potential causes of FUO, thereby improving clinical diagnosis of this disorder.In this retrospective study, clinical data were collected from 215 patients who were diagnosed with FUO between January 2009 and December 2010, and an 18 to 36 months follow-up visit was also performed for these patients.Among these FUO cases, the most common causes of the disease were infectious diseases (IDs) (42...
June 2018: Medicine (Baltimore)
Sarah Vella, Bernard Coleiro, Charles Mallia Azzopardi
We report a case of Cogan's syndrome presenting as fever of unknown origin in a 31-year-old woman who was admitted to the hospital with a 7-week history of fever, night sweats and other constitutional symptoms. The diagnosis remained elusive despite numerous investigations, and the patient subsequently developed rash, episcleritis, dizziness and sensorineural hearing loss. While initially thought to be a postinflammatory response to a previous infection, confirmation of the rash as a vasculitis together with the audiovestibular and ocular involvement led to a clinical diagnosis of Cogan's syndrome...
June 4, 2018: BMJ Case Reports
Pia U Olafson, Donald B Thomas, Melinda A May, Beverly G Buckmeier, Roberta A Duhaime
Nilgai ( Boselaphus tragocamelus) are nonnative bovines that were originally introduced as game animals to one large, South Texas ranch but that are now present throughout southeastern Texas from Baffin Bay to Harlingen and in northern Mexico at least as far west as Durango. Between October 2014 and January 2017, nilgai ( n=517) were examined for the presence of tick ectoparasites, with particular interest in the cattle fever tick, Rhipicephalus ( Boophilus) microplus. These animals were either hunter killed or they were culled as part of federal cooperative harvesting from Cameron and Willacy counties in southeastern Texas...
June 4, 2018: Journal of Wildlife Diseases
Felipe S Krawczak, Marcelo B Labruna, Joy A Hecht, Christopher D Paddock, Sandor E Karpathy
The bacterium Rickettsia bellii belongs to a basal group of rickettsiae that diverged prior to the pathogenic spotted fever group and typhus group Rickettsia species. Despite a diverse representation of R. bellii across more than 25 species of hard and soft ticks in the American continent, phylogeographical relationships among strains of this basal group- Rickettsia species are unknown; the work described here explores these relationships. DNA was extracted from 30 R. bellii tick isolates: 15 from the United States, 14 from Brazil, and 1 from Argentina...
2018: BioMed Research International
Keiki Nagaharu, Masahiro Masuya, Yuki Kageyama, Takanori Yamaguchi, Ryugo Ito, Keiki Kawakami, Masafumi Ito, Naoyuki Katayama
BACKGROUND: Hodgkin lymphoma usually presents with sequential enlargement of peripheral lymph nodes, and bone marrow invasion rarely occurs (approximately 3-5%). However, several cases have been reported as "primary" bone marrow Hodgkin lymphoma, especially among patients with human immunodeficiency virus and the elderly. This type of Hodgkin lymphoma is characterized by no peripheral lymphadenopathies and has been reported to have poorer prognosis. CASE PRESENTATION: A 38-year-old Japanese man was admitted to our hospital because of fever of unknown origin and pancytopenia without lymphadenopathies...
May 30, 2018: Journal of Medical Case Reports
Voahangy Andrianaivoarimanana, Eric Bertherat, Rojo Rajaonarison, Tiana Rakotondramaro, Christophe Rogier, Minoarisoa Rajerison
BACKGROUND: Plague is a life-threatening disease caused by the bacterium, Yersinia pestis. Madagascar is the leading country for human plague cases worldwide. Human plague is a serious disease, particularly in its septicaemic and pneumonic forms. We report a case of pneumonic plague co-infected by a MDR-Stenotrophomonas maltophilia. CASE PRESENTATION: A 24 year-old man originated from Soavinandriana, a plague focus, felt uneasy and developed high fever with chills...
May 29, 2018: BMC Pulmonary Medicine
A L Booth, P Osehobo, D Rodgers-Soriano, A Lalarukh, M A Eltorky, H L Stevenson
Hemophagocytic lymphohistiocytosis (HLH) is an uncommon disease that often presents with nonspecific findings. A high index of suspicion is necessary to make a prompt diagnosis and prevent fatal disease. A 45-year-old man presented with fever, hypotension, abdominal pain, nausea, and vomiting. Imaging showed hepatosplenomegaly and laboratory tests revealed pancytopenia, increased ferritin, and a cholestatic pattern of injury with elevated alkaline phosphatase and total bilirubin. Due to a history of Crohn disease, systemic lupus erythematous, and rheumatoid arthritis, the patient was on immunosuppressants, including infliximab...
January 2018: Case Reports in Gastroenterology
Nicolaus Kröger, Sharifah Shahnaz Syed Abd Kadir, Tatjana Zabelina, Anita Badbaran, Maximilian Christopeit, Francis Ayuk, Christine Wolschke
JAK inhibition by Ruxolitinib is approved for treatment of myelofibrosis and showed efficacy in steroid resistant acute and chronic graft-versus-host disease (GVHD) In twelve patients with a median age of 63 years (range 43-71) and myelofibrosis who were treated with ruxolitinib and underwent allogeneic stem cell transplantation (ASCT) ruxolitinib was continued (2 x 5mg) daily until stable engraftment. No graft failure was observed and leukocyte engraftment was achieved after a median of 12 days (range 11 - 18) One patient developed fever of unknown origin after discontinuation of ruxolitinib, otherwise no case of withdrawal syndrome was observed...
May 22, 2018: Biology of Blood and Marrow Transplantation
Masao Hagihara, Toru Mese, Shin Ohara, Jian Hua, Shiro Ide, Morihiro Inoue
we herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred within a year, so the patient was suspected of having an MTX-associated lymphoproliferative disorder. His clinical symptoms resolved after the cessation of MTX. However, after treatment with iguratimod, another disease-modified anti-rheumatic drug, markedly similar symptoms recurred, and random skin biopsies resulted in a diagnosis of IVLBCL...
May 18, 2018: Internal Medicine
Juan Jose Martin-Marcuartu, Jose Antonio Lojo-Ramirez, Victor Manuel Pachón-Garrudo, José Manuel Jimenez-Hoyuela
No abstract text is available yet for this article.
May 15, 2018: Medicina Clínica
M Ponraj, Biswajit Dubashi, B H Harish, S Kayal, S L Cyriac, Jogamaya Pattnaik, K Ranjith, Unni S Pillai, Naresh Jadhav, Kiran K Matta, Jagdeep Singh, Esha Jaffa, Bhanu Prakash
PURPOSE: Beta lactams are standard empirical therapy for febrile neutropenia (FN). The aim of this study was to evaluate the efficacy and safety of cefepime monotherapy compared with cefoperazone/sulbactam plus amikacin (CS + A) for empirical treatment of high risk FN. METHODS: One hundred seventy-five patients with 336 FN episodes were randomized to receive either cefepime (2 g q8h for adults and 50 mg/kg q8h for children) or CS (2 g q8h for adults and 50 mg/kg q8h for children) plus amikacin (15 mg/kg once a day)...
May 17, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Xinxin Liu, Jian Yang, Shuang Song, Hong Song, Danni Ai, Jianjun Zhu, Yurong Jiang, Yongtian Wang
Liver metabolic information is considered as a crucial diagnostic marker for the diagnosis of fever of unknown origin, and liver recognition is the basis of automatic diagnosis of metabolic information extraction. However, the poor quality of PET and CT images is a challenge for information extraction and target recognition in PET-CT images. The existing detection method cannot meet the requirement of liver recognition in PET-CT images, which is the key problem in the big data analysis of PET-CT images. A novel texture feature descriptor called multi-layer cube sampling (MLCS) is developed for liver boundary detection in low-dose CT and PET images...
May 17, 2018: Australasian Physical & Engineering Sciences in Medicine
Yi Zhang, Chen Zhang, Bo Li, Yang Li, Xiao Zhou He, Acher Li, Wei Wu, Su Xia Duan, Fang Zhou Qiu, Ji Wang, Xin Xin Shen, Meng Jie Yang, De Xin Li, Xue Jun Ma
OBJECTIVE: Unbiased next generation sequencing (NGS) is susceptible to interference from host or environmental sequences. Consequently, background depletion and virome enrichment techniques are usually needed for clinical samples where viral load is much lower than background sequences. METHODS: A viral Sequence Independent Targeted Amplification (VSITA) approach using a set of non-ribosomal and virus-enriched octamers (V8) was developed and compared with traditionally used random hexamers (N6)...
April 2018: Biomedical and Environmental Sciences: BES
Tai-Ming Ko, Kazuma Kiyotani, Jeng-Sheng Chang, Jae-Hyun Park, Poh Yin Yew, Yuan-Tsong Chen, Jer-Yuarn Wu, Yusuke Nakamura
Identifying the causes of high fever syndromes such as Kawasaki disease (KD) remains challenging. To investigate pathogen exposure signatures in suspected pathogen-mediated diseases like KD, we performed immunoglobulin (Ig) profiling using a next-generation sequencing method. After intravenous Ig (IVIG) treatment, we observed disappearance of clonally expanded IgM clonotypes, which were dominantly observed in acute-phase patients. The complementary-determining region 3 (CDR3) sequences of dominant IgM clonotypes in acute-phase patients were commonly observed in other Ig isotypes...
May 16, 2018: Human Molecular Genetics
Luciano Attard, Marina Tadolini, Domenico Umberto De Rose, Marco Cattalini
Fever of unknown origin (FUO) can be caused by a wide group of diseases, and can include both benign and serious conditions. Since the first definition of FUO in the early 1960's, several updates to the definition, diagnostic and therapeutic approaches have been proposed. This review outlines a case report of an elderly Italian male patient with high fever and migrating arthralgia who underwent many procedures and treatments before a final diagnosis of Adult-onset Still's disease was achieved. This case report highlights the difficulties in diagnosing certain causes of FUO that requires a very high index of suspicion...
January 2018: Clinical and Experimental Rheumatology
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