scholarly journals Fever of Unknown Origin: An Unusual Presentation of Kikuchi-Fujimoto Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Piyush Ranjan ◽  
Manish Soneja ◽  
Nellai Krishnan Subramonian ◽  
Vivek Kumar ◽  
Shuvadeep Ganguly ◽  
...  
Keyword(s):  
Fever Of Unknown Origin ◽  
Cervical Lymphadenopathy ◽  
Unknown Origin ◽  
Accurate Diagnosis ◽  
Diagnostic Dilemma ◽  
Delay In Diagnosis ◽  
Young Females ◽  
Common Presentation ◽  
Limiting Condition ◽  
High Index Of Suspicion

Kikuchi-Fujimoto disease is a rare, benign, and self-limiting condition that mostly affects young females. Cervical lymphadenopathy with fever is the most common presentation of the disease. It may have unusual presentations that can lead to diagnostic dilemma and delay in diagnosis. We report a case of a 25-year-old female who presented with relapsing fever and cervical lymphadenopathy. Because of atypical presentation, there was a delay in diagnosis and increase in morbidity. High index of suspicion with collaboration between clinicians and pathologists is essential for early and accurate diagnosis of the disease.

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 Threat of scrub typhus in post-earthquake Nepal

2017 ◽  
Vol 6 (4) ◽  
pp. 1-6 ◽  
Author(s):  
S Thapa ◽  
L B Sapkota ◽  
P Hamal
Keyword(s):  
Fever Of Unknown Origin ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Unknown Origin ◽  
Serum Samples ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Recent Outbreak ◽  
High Index Of Suspicion ◽  
A Prospective Study

Scrub typhus is a potentially fatal zoonotic infection, reported from many parts of Asia including Nepal. There is in­creasing reports of outbreak of Scrub typhus, after the earthquake hit Nepal on April 25, 2015. The recent outbreak of Scrub typhus posed problems in diagnosis and treatment of the disease. It may be related to poor awareness of the disease or lack of suspicion for Scrub typhus which often presents with clinical features indistinguishable from typhoid fever. Since, various parts of Nepal appeared to be suitable hubs for Scrub typhus, the clinical suspicion of Scrub typhus in the differential diagnosis of fever of unknown origin (FUO) is of utmost importance to prevent mortality and morbidity. This is a prospective study conducted in Chitwan Medical College (CMC), Chitwan, Nepal. This study was carried out over a period of 4 months extending from June 2016 to September 2016. A total of 410 serum samples were collected from all patients visiting CMC, clinically suspected of having Scrub typhus infec­tion. The samples were processed for the detection of IgM antibodies for Scrub typhus by ELISA. Results: A total of 410 samples from patients suspected with Scrub typhus infection were processed which included 200 males and 210 females. Out of total 410 samples tested, 181 (44.1%) were seropositive for Scrub typhus. Seropositivity was highest 25.9% among the age group 11-20 years of age. Females were infected more than males. This study implies the re-emergence of Scrub typhus in different regions of Nepal. Although the disease is endemic in our country, it is grossly underdiagnosed owing to non-specific clinical presentation and lack of diagnostic facilities. It is thus suggested that high index of suspicion should be maintained for cases presenting with febrile illness. Infection with Scrub typhus was found high and this calls for an urgent need to introduce vaccine against Scrub typhus. 

scholarly journals CONVENTIONAL AND RECENT DIAGNOSTIC AIDS IN TUBERCULOUS LYMPHADENITIS: A BRIEF OVERVIEW

2017 ◽  
Vol 10 (2) ◽  
pp. 78
Author(s):  
Shamimul Hasan ◽  
Shazina Saeed
Keyword(s):  
Public Health ◽  
Cervical Lymphadenopathy ◽  
Accurate Diagnosis ◽  
Tuberculous Lymphadenitis ◽  
Extra Pulmonary Tuberculosis ◽  
Young Females ◽  
Gender And Age ◽  
Public Health Threat ◽  
Extra Pulmonary ◽  
Dental Professionals

One of the most common form of extra-pulmonary tuberculosis is peripheral tuberculous lymphadenitis and accounts for 20-40% of the cases. Tuberculous lymphadenitis has a gender and age predilection (usually seen in young females).  It is usually bilateral in presentation and is non-contagious. Recent upsurge in HIV co-infection has challenged the diagnosis and management of tuberculosis and of associated lymphadenopathy. In the endemic areas, tuberculous lymphadenitis remains an important and essential differential diagnosis in patients presenting with cervical swellings.  A timely and accurate diagnosis is mandatory to overcome this public health threat. Interdisciplinary involvement of varied medical and dental professionals enhances the possibility of an effective and timely diagnosis of this condition. Keywords: Cervical lymphadenopathy, Diagnosis, Management, Tuberculosis.

scholarly journals Fever of Unknown Origin - A Child With an Unusual Case of Juvenile Idiopathic Arthritis

2020 ◽  
Vol 4 (1) ◽  
pp. 459-461
Author(s):  
Purnima Gyawali ◽  
Deepika Gyawali ◽  
Sharda Acharya
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Fever Of Unknown Origin ◽  
Pediatric Population ◽  
Unknown Origin ◽  
Diagnostic Challenge ◽  
Laboratory Assessment ◽  
Medical College ◽  
Unexplained Fever ◽  
History Of ◽  
High Index Of Suspicion

Fever of unknown origin in the pediatric population is fever >38.3°C (101°F) of at least seven days' duration, in which no diagnosis is apparent after initial outpatient or hospital evaluation that includes a careful history and physical examination and initial laboratory assessment. Fever of unknown origin is a diagnostic challenge, with a broad spectrum of causes classified as infectious, malignant/neoplastic, rheumatic/inflammatory, and miscellaneous disorders. A high index of suspicion should be kept for juvenile idiopathic arthritis in children presenting with unexplained fever and joint symptoms and should be appropriately managed. The case described here is of a 13-year-old female from Nepal, who presented to the Pediatric outpatient department of KIST Medical College and Teaching Hospital with a history of fever and arthralgia for three months.

scholarly journals 18F-FDG PET/CT contribution to tuberculous vertebral osteomyelitis diagnosis: a case report

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Katerina Manika ◽  
Maria Kipourou ◽  
Stamata Georga ◽  
Eleni Faniadou ◽  
Georgios Pilianidis ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Fever Of Unknown Origin ◽  
Extrapulmonary Tuberculosis ◽  
Vertebral Osteomyelitis ◽  
Unknown Origin ◽  
Future Perspectives ◽  
Valuable Contribution ◽  
Delay In Diagnosis ◽  
Pet Ct ◽  
Fdg Pet Ct

ABSTRACT Tuberculous vertebral osteomyelitis (TVO) is an extrapulmonary tuberculosis form characterized by difficulty and delay in diagnosis. PET/CT is a valuable, well-established tool in the diagnostic workup of cancer and fever of unknown origin, which is increasingly appreciated in the management of infectious diseases. We report a TVO case where PET/CT had a valuable contribution towards diagnosis and monitoring of treatment response, highlighting its advantages and future perspectives when dealing with infectious diseases.

scholarly journals Fever of Unknown Origin as a Sole Presentation of Subacute Thyroiditis in an Elderly Patient: A Case Report with Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Rishi Raj ◽  
Srujana Yada ◽  
Aasems Jacob ◽  
Dileep Unnikrishnan ◽  
Wael Ghali
Keyword(s):  
Elderly Patient ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Laboratory Studies ◽  
High Index Of Suspicion ◽  
Very High ◽  
Rule Out

An 80-year-old Caucasian male presented with fever of 3-week duration. Outpatient workup for infectious etiologies was negative and due to persistent fever, he was hospitalized for further evaluation of fever of unknown origin (FUO). Physical examination and laboratory studies remained unremarkable; however a follow-up CT scan of chest, abdomen, and pelvis with contrast done to rule out malignancy as an underlying cause of FUO revealed heterogeneous thyroid gland with surrounding hazy changes suggestive of thyroiditis. Thyroid function tests confirmed the diagnosis of subacute thyroiditis. The patient was started on prednisone with good response in his symptoms and was eventually discharged to home. The importance of our case lies in the fact that diagnosing subacute thyroiditis in the absence of classical symptoms of neck pain can be challenging and a physician should have a very high index of suspicion especially in an elderly patient where FUO can be the sole presentation.

scholarly journals Role of Coxiella burnetii in the development of fever of unknown origin: А mini review

2019 ◽  
Vol 22 (3) ◽  
pp. 251-265
Author(s):  
P. Genova-Kalou ◽  
S. Ivanova ◽  
A. Pavlova ◽  
K. Simeonov ◽  
D. Pencheva ◽  
...  
Keyword(s):  
Fever Of Unknown Origin ◽  
Clinical Presentation ◽  
Q Fever ◽  
Unknown Origin ◽  
Accurate Diagnosis ◽  
Diagnostic Methods ◽  
Molecular Diagnostic ◽  
Agricultural Systems ◽  
The World

Q fever is a widespread zoonosis throughout the world in the form of numerous natural and agricul-tural outbreaks. C. burnetii infects various hosts, including humans, ruminants and pets and in rare cases, reptiles, birds, and ticks. This bacterium is excreted in urine, milk, faeces, and birth products. In humans Q fever occurs as acute or chronic disease with diverse clinical presentation, as isolated cases and epidemics. It affects various organs and systems, and in pregnant women can cause miscar-riage or premature birth. Untreated Q fever can become chronic with adverse effects on patients. Diversity in the clinical picture in the absence of specific pathological syndrome often hinders accurate diagnosis and proper etiological significance. Therefore, improvement of diagnostic methods and in particular the development and introduction of new molecular diagnostic methods is the basis of effective therapeutic and prophylactic approach. Тhe purpose of the review is to renew the interest to Q fever – on one hand, because of its serious impact on human health and agricultural systems, and on the other, the ability for development and introduction of new molecular diagnostic methods.

scholarly journals Brucellosis - diagnostic dilemma: Case report

2002 ◽  
Vol 130 (3-4) ◽  
pp. 95-99
Author(s):  
Biljana Bojic ◽  
Milica Vujosevic ◽  
Svetlana Nikolic ◽  
Olga Dulovic ◽  
Jelica Grebenarevic ◽  
...  
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Medical Practice ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Epidemiological Data ◽  
Domestic Animals ◽  
Symptomatic Therapy ◽  
Diagnostic Dilemma ◽  
General Medical Practice

The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headacke and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals this might be the reason of the acquired infection. With appropriate antibiotic therapy (aminoglycoside, doxicyclin, rifampicin), symptomatic therapy and rehabilitation the disease had favorable outcome; there was no recidive. The authors point out the importance of specific microbiological examinations of patients with fever of unknown origin, especially if the patient has the symptoms that are compatible with brucellosis. In our case it was sacroileitis, as a characteristic complication. As brucellosis is endemic in some parts of our country, there is always a possibility of brucellosis in general medical practice.

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