scholarly journals A Case of Polyarteritis Nodosa Associated with Cytomegalovirus Infection

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Maiko Kouchi ◽  
Shinji Sato ◽  
Masahiro Kamono ◽  
Akiko Taoda ◽  
Kazuyuki Iijima ◽  
...  
Keyword(s):  
Polyarteritis Nodosa ◽  
Therapeutic Strategy ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Biceps Muscle ◽  
Cmv Infection ◽  
Mononeuritis Multiplex ◽  
Left Lower Extremity ◽  
Leg Edema ◽  
The Right

A 77-year-old man suffering from prolonged fever of unknown origin and bilateral leg edema was referred to our hospital. On physical examination, he had fever, general fatigue, bilateral lower leg edema, and muscle weakness of the right upper extremity and left lower extremity. Neurological examination indicated motor and sensory disturbance. Electromyography revealed mononeuritis multiplex and myopathy. A biopsy of the left biceps muscle indicated necrotizing vasculitis with fibrinoid necrosis. Considering all the data together, he was diagnosed as having polyarteritis nodosa (PAN) and concurrent active cytomegalovirus (CMV) infection. His symptoms improved promptly on treatment with 50 mg of prednisolone. This case emphasizes the importance of CMV infection as one of possible etiologies of PAN and reports a therapeutic strategy for this syndrome.

scholarly journals Giant criptogenic pyogenic gas containing left liver abscess

2008 ◽  
Vol 136 (5-6) ◽  
pp. 292-294
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Vladimir Radak
Keyword(s):  
Escherichia Coli ◽  
Liver Abscess ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diabetic Patients ◽  
Surgical Drainage ◽  
X Ray ◽  
Left Liver ◽  
Liver Abscesses ◽  
The Right

INTRODUCTION Pyogenic gas containing liver abscesses are rare. Less than 50 cases seem to have been described so far. Most of them were localised within the right liver. The majority of those abscesses appear in diabetic patients. CASE OUTLINE The authors present a 64-year old diabetic male patient in whom the investigation (US, CT, plain X-ray) performed for fever of unknown origin confirmed a giant liver gas containing abscess that destroyed almost the entire left liver. Escherichia coli sensitive to several antibiotics was isolated from the abscess. The patient was cured by surgical drainage, limited debridement, lavage, drainage and antibiotics. CONCLUSION Pyogenic gas containing liver abscesses are easy to diagnose nowadays. The type of surgical drainage has to be adapted to a particular patient.

scholarly journals Intravascular Lymphoma of the Inferior Turbinate: An Unusual Rhinologic Presentation of a Rare Neoplasm

2007 ◽  
Vol 22 (1-2) ◽  
pp. 24-26 ◽  
Author(s):  
Milabelle B. Lingan ◽  
Francis V. Roasa
Keyword(s):  
Fever Of Unknown Origin ◽  
Medical Condition ◽  
Unknown Origin ◽  
Inferior Turbinate ◽  
Tertiary Hospital ◽  
Sinus Surgery ◽  
Intravascular Lymphoma ◽  
High Grade Fever ◽  
The Right ◽  
High Index Of Suspicion

Objective: To present a unique case of intravascular lymphoma of the inferior turbinate because of its rarity, unusual clinical presentation and difficulty in establishing a diagnosis. Design:      Case Report Setting:      A tertiary hospital Patient:      A 66-year-old male admitted to the hospital due to intermittent high grade fever of six months duration. Result:  The patient presented with fever of unknown origin, and exhaustive laboratory, ancillary procedures and biopsies to rule in/out infectious, autoimmune and oncologic causes were performed to arrive at a diagnosis. Nasal endoscopy revealed an enlarged, hypertrophied and violaceous right inferior turbinate with watery to mucoid discharge and septal deviation to the right confirmed by CT scans of the paranasal sinuses. Functional Endoscopic Sinus Surgery (FESS), septoplasty and turbinoplasty with biopsy revealed Intravascular Lymphoma. Chemotherapy was deferred due to the deteriorating medical condition and the patient expired 7 months after the initial onset of symptoms. Conclusion:  Patients who present with fever of unknown origin should undergo a thorough otorhinolaryngologic examination to exclude primary ENT conditions and ensure proper management. Given its rarity and multiplicity of presentation, it is extremely difficult to make a diagnosis of intravascular lymphoma. A high index of suspicion of Intravascular Lymphoma is necessary so that timely acquisition of tissue biopsy of any lesion involved will make a definite diagnosis. Keywords: Intravascular lymphoma, Fever, Fever of Unknown Origin

scholarly journals Spontaneous Occurrence of Gangrene Due to Clostridium septicum in a Patient With Advanced Endometrial Carcinoma

1994 ◽  
Vol 2 (1) ◽  
pp. 34-37 ◽  
Author(s):  
David H. Moore ◽  
Kris Ghosh ◽  
Gregory P. Sutton
Keyword(s):  
Fever Of Unknown Origin ◽  
Surgical Intervention ◽  
Endometrial Adenocarcinoma ◽  
Unknown Origin ◽  
White Female ◽  
Clostridium Septicum ◽  
Blue Discoloration ◽  
Wbc Count ◽  
The Right ◽  
Dark Blue

Background: We report the first known case of spontaneous, atraumatic Clostridium septicum gangrene occurring in a patient with recurrent endometrial adenocarcinoma.Case: A 63-year-old white female undergoing chemotherapy for recurrent endometrial adenocarcinoma presented with right “arthritis-like” shoulder pain. She denied fever, chills, or shoulder trauma. The patient was afebrile and her blood pressure was 100/50. Her right shoulder and upper extremity were remarkable for an area of dark blue discoloration with crepitus. The white blood cell (WBC) count was 8,200/μl with left shift. Serum creatinine, platelet count, and coagulation studies were normal. Computed tomography revealed gas in the right shoulder tissues. A Gram stain of fluid aspirated from the shoulder demonstrated gram-positive spore-forming rods. She declined surgical intervention and expired within hours of admission. Cultures of the right shoulder eventually grew Clostridium septicum.Conclusion: It is imperative to consider clostridial gangrene in the differential diagnosis for any patient with cancer and a fever of unknown origin.

Febbre di origine sconosciuta (FUO): approccio diagnostico attraverso un caso clinico

2020 ◽  
Vol 39 (8) ◽  
pp. 519-525
Author(s):  
Davide Ursi ◽  
Simona Puzone ◽  
Caterina Strisciuglio
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Full Blood Count ◽  
Common Disease ◽  
Cmv Infection ◽  
Immunosuppressant Therapy ◽  
Unusual Manifestation ◽  
Therapy Methotrexate

The paper reports the case of a 12-year-old female affected by ulcerative colitis and treated with double immunosuppressant therapy (methotrexate and infliximab). The patient presented with 7 day-lasting fever associated with pharyngotonsillar hyperaemia, cheilitis, vesicular-bollous lesions on labial mucosa and rash on malar regions, chest and upper extremities. Since full blood count showed lymphocytosis and inflammatory markers were negative, a viral infection was suspected. Virological tests identified the presence of IgM against Cytomegalovirus (CMV), Herpes and Mumps viruses, but Real-Time PCR was negative for the DNA detection of any of those viruses. Despite hospital admission and different investigations, fever persisted for more than 7 days without any explanation. Therefore, it was considered as Fever of unknown origin (FUO). FUO is often an unusual manifestation of a common disease but so far there is not a single validated diagnostic protocol. In the presented case only did the repetition of the Real-Time PCR test after a few days enable CMV DNA to be identified in the patient’s blood and urine and CMV infection to be diagnosed.

Case 1.21

2014 ◽  
pp. 41-42
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Signal Intensity ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
New Right ◽  
History Of ◽  
The Right

14-year-old boy with a 1-year history of episodic fever of unknown origin; he presents with new right-sided abdominal pain Coronal SSFSE (Figure 1.21.1) and axial fat-suppressed FSE T2-weighted (Figure 1.21.2) images demonstrate a lobulated heterogeneous mass involving both the right and left hepatic lobes with regions of mildly increased signal intensity relative to adjacent liver. The mass is hypointense on axial IP and OP T1-weighted 2D SPGR images (...

scholarly journals Ankylosing spondylitis presenting with enthesitis at an uncommon site and fever of unknown origin

2019 ◽  
Vol 12 (8) ◽  
pp. e230113
Author(s):  
Naoki Kanda ◽  
Koichi Takeda ◽  
Shuji Hatakeyama ◽  
Masami Matsumura
Keyword(s):  
Ankylosing Spondylitis ◽  
Sacroiliac Joint ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Temporal Region ◽  
Thoracic Vertebrae ◽  
Temporal Muscle ◽  
Radiographic Findings ◽  
History Of ◽  
The Right

A 58-year-old man presented with a 2-month history of arthralgia and bilateral temporal region pain, and a 1-month history of fever. He had had refractory neck pain since his 20s. Reduced cervical and lumbar mobility was observed. Radiographs of cervical and thoracic vertebrae disclosed syndesmophytes. Pelvic radiographs showed sclerosis in the right sacroiliac joint and ankylosis in the left sacroiliac joint. MRI with contrast enhancement showed enthesitis in the upper extremities and enhancement in the bilateral temporal muscle, which indicated enthesitis of temporal muscle. He was diagnosed with ankylosing spondylitis based on the limitation in mobility of the lumbar spine and radiographic findings. To the best of our knowledge, this is the first report describing enthesitis of the temporal muscle. This case highlights that ankylosing spondylitis can be accompanied with enthesitis at the temporal muscle and fever of unknown origin at the initial presentation.

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