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Unknown origin fever

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https://read.qxmd.com/read/31700940/a-7-year-old-child-with-headaches-and-prolonged-fever-associated-with-oral-and-nail-lesions
#1
Sophie Martin, Elise Balligand, Julie Peeters, Marie-Cécile Nassogne, Bénédicte Mondovits, Michèle Loop, Ariel de Selys, Jean Vanclaire, Christiane Vermylen, Jean-Jacques De Bruyckere, Olga Chatzis, Anne Puel, Olivier Gilliaux, Dimitri Van Der Linden
A 7-year-old child of Turkish origin presented with headache and vomiting in the context of prolonged fever of unknown source. At examination, oral candidiasis and chronic onychomycosis were noted. A Candida meningoencephalitis was diagnosed and intravenous Amphotericin B liposomal was given during 6 months relayed by oral Fluconazole after regression of CNS lesions was observed on MRI. A complete immune evaluation was performed, and genetic analysis detected homozygous CARD9 mutation. CARD9 deficiency have been associated with invasive candidiasis in otherwise healthy patients...
November 2019: Open Forum Infectious Diseases
https://read.qxmd.com/read/31696861/cryptococcosis-masquerading-as-disseminated-tuberculosis-in-a-patient-on-chronic-hemodialysis
#2
Priti Meena, Anurag Gupta, Lovy Gaur, Aakash Shingada, Pallav Gupta, Vinant Bhargava, Devender S Rana
Chronic hemodialysis (HD) recipients are nearly ten times more prone to fungal infections compared to the general population. However, infections such as cryptococcosis usually affect immunocompromised patients, unusual in otherwise immunocompetent patients. Here, we describe a unique case of cryptococcosis in a human immunodeficiency virus negative end-stage renal disease (ESRD) patient. A 26-year-old female patient, diagnosed with ESRD, on maintenance HD for the past six months, presented with pyrexia of unknown origin associated with cervical lymphadenopathy, biopsy of which showed granulomatous inflammation...
September 2019: Saudi Journal of Kidney Diseases and Transplantation
https://read.qxmd.com/read/31695516/imported-brucellosis-in-the-era-of-dramatically-increasing-immigrants-and-foreign-travelers-from-endemic-areas-occupational-hazards-of-secondary-infection-among-laboratory-technicians-in-a-nonendemic-country
#3
Takahiko Fukuchi, Nobue Yanagihara, Koichi Imaoka, Hitoshi Sugawara
Background: Brucellosis, an important zoonotic disease, is endemic in various parts of the world. Patients diagnosed with brucellosis in developed countries are often travelers and immigrants from endemic areas. This pathogen is listed as biosafety level 3, which means that it is highly contagious and therefore a risk to clinical laboratory technicians. Case presentation: A 43-year-old Chinese man, who could not understand Japanese, visited our hospital because of an intermittent fever that had persisted for 5 months...
2019: International Medical Case Reports Journal
https://read.qxmd.com/read/31689293/average-and-time-specific-maternal-prenatal-inflammatory-biomarkers-and-the-risk-of-labor-epidural-associated-fever
#4
Dominique Y Arce, Andrea Bellavia, David E Cantonwine, Olivia J Napoli, John D Meeker, Tamarra James-Todd, Thomas F McElrath, Lawrence C Tsen
BACKGROUND: The use of labor epidural analgesia has been associated with intrapartum fever, known as labor epidural associated fever (LEAF). LEAF is most commonly non-infectious in origin and associated with elevated inflammatory cytokines. METHODS: The LIFECODES pregnancy cohort was designed to prospectively collect data to evaluate the association of maternal inflammatory biomarkers with preterm birth in women who delivered between 2007 and 2008 at Brigham and Women's Hospital...
2019: PloS One
https://read.qxmd.com/read/31667604/is-current-initial-empirical-antibiotherapy-appropriate-to-treat-bloodstream-infections-in-short-duration-chemo-induced-febrile-neutropenia
#5
A Joncour, M Puyade, A Michaud, J-M Tourani, F Cazenave-Roblot, Blandine Rammaert
INTRODUCTION: Fever of unknown origin is by far the most common diagnosis in low-risk febrile neutropenic patients undergoing chemotherapy. The current empirical regimen combines amoxicillin-clavulanic acid and fluoroquinolones in low-risk neutropenic patients. The aim of this study was to assess the appropriateness of antibiotherapy and the outcome of bloodstream infections (BSI) in patients with expected neutropenia of short duration. METHODS: This 2-year monocentric retrospective study included all consecutive neutropenic febrile adult patients with expected duration of neutropenia ≤ 7 days...
October 31, 2019: Supportive Care in Cancer
https://read.qxmd.com/read/31640598/acute-liver-failure-due-to-visceral-leishmaniasis-in-barcelona-a-case-report
#6
Iratxe Martinez de Narvajas, Alba Díaz, Octavio Bassegoda, Adriá Carpio, Carla Fuster, María Eugenia Valls, Miriam J Alvarez-Martínez, Carolina García-Vidal, Alejandro Soriano, José Antonio Martínez, Juan Ambrosioni
BACKGROUND: Leishmaniasis is an emerging infectious disease. Due to human migration and tourism, visceral leishmaniasis may become more common in non-endemic areas. In the Mediterranean basin, visceral leishmaniasis typically occurs in rural regions. CASE PRESENTATION: We present an unusual urban case of acute liver failure due to visceral leishmaniasis, following a prolonged fever of unknown origin. After obtaining negative results from the bone marrow aspirate, we performed a liver biopsy that elucidated the diagnosis...
October 22, 2019: BMC Infectious Diseases
https://read.qxmd.com/read/31624756/hemophagocytic-lymphohistiocytosis-complicated-by-polyserositis-a-case-report
#7
Ping Zhu, Qing Ye, Ting-Hong Li, Tao Han, Feng-Mei Wang
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare group of disorders of immune dysregulation characterized by clinical symptoms of severe inflammation. There are basically two types of clinical scenarios: Familial HLH and sporadic HLH. It is thought that the syndrome is implicated in the development of infections, malignancies, and autoimmune diseases. HLH, whether primary or secondary, is characterized by activated macrophages in hematopoietic organs, hepatosplenomegaly, cytopenia, and fever; however, HLH complicated with polyserositis (PS) has never been reported...
October 6, 2019: World Journal of Clinical Cases
https://read.qxmd.com/read/31620688/tuberculosis-mastitis-fever-of-unknown-origin-in-a-kidney-transplant-recipient
#8
Göktuğ Sarıbeyliler, Sevgi Saçlı Alimoğlu, Şafak Mirioğlu, Erol Demir, Atahan Çağatay, Halil Yazıcı
Tuberculous mastitis is a rare presentation of tuberculosis, which is a major health problem in kidney transplant recipients due to its high incidence and prevalence, and difficulty in diagnosis as well as high risk of morbidity and mortality. In daily practice, physicians may frequently be led to a misdiagnosis such as breast carcinoma or abscess. We believe it is crucial for clinicians to recognize this important presentation of the disease. Therefore, we present a case of tuberculous mastitis in a kidney transplant recipient who was admitted with fever of unknown origin and successfully treated using standard anti-tuberculosis therapy without any complications...
October 2019: European Journal of Breast Health
https://read.qxmd.com/read/31604648/diagnostic-performance-of-fdg-pet-ct-in-critically-ill-patients-with-suspected-infection-a-systematic-review-and-meta-analysis
#9
Chun-Kai Huang, Jei-Yie Huang, Sheng-Yuan Ruan, Kuo-Liong Chien
BACKGROUND/PURPOSE: Nuclear imaging, including gallium scintigraphy and fluorodeoxyglucose (FDG) positron emission tomography (PET), has been widely used to identify focus of infection in fever of unknown origin. However, little is known about its role in critically ill patients, who are usually with multiple inflammatory foci and unable to tolerate long image acquisition time. This systematic review aimed to evaluate the diagnostic performance of FDG PET for suspected infection in critically ill patients...
October 8, 2019: Journal of the Formosan Medical Association
https://read.qxmd.com/read/31603071/periodic-fever-aphthous-stomatitis-pharyngitis-and-cervical-adenitis-in-chinese-adult-patients
#10
Di Wu, Min Shen, Xiaofeng Zeng
OBJECTIVES: Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a multifactorial autoinflammatory disease (AID), which mainly affects children. There have been hardly any cases reported concerning the Chinese population. We aimed to describe the first cohort of adult PFAPA patients in China. METHODS: We evaluated all the adult patients suffering from PFAPA syndrome diagnosed in our centre from April 2015 through March 2018...
October 10, 2019: Clinical and Experimental Rheumatology
https://read.qxmd.com/read/31579229/thyroid-scintigraphy-in-fever-of-unknown-origin
#11
Rashmi Ranjan Mohanty, Kanhaiyalal Agrawal, Bikash Ranjan Meher
Thyroiditis is a very rare cause of fever of unknown origin (FUO). Thyroiditis presenting as only fever and weight loss is very rare. We present a case of FUO, which was later on confirmed as thyroiditis on thyroid scintigraphy.
October 2019: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://read.qxmd.com/read/31555506/mycobacterium-avium-prosthetic-hip-infection-on-abatacept-presenting-as-fever-of-unknown-origin
#12
Rachel Sigler, Jessica R Newman
Non-tuberculous mycobacteria (NTM) are well-described pulmonary pathogens in patients with underlying lung disease. Extra-pulmonary infections with NTM are rare. We describe a prosthetic hip infection with Mycobacterium avium complex. Increased immunosuppressing medications and number of total joint replacements are expected to increase the prevalence of NTM infections in the future.
2019: Journal of Bone and Joint Infection
https://read.qxmd.com/read/31542066/grover-s-disease-in-a-kidney-transplant-recipient
#13
Jason Kirincich, Davorin Lončarić, Zrinka Bukvić Mokos, Nikolina Bašić-Jukić
Dear Editor, It is not unusual for patients with renal insufficiency to develop skin pathologies. There are reports in the literature of increased incidence of calciphylaxis, pruritus, perforating dermatoses, and porphyria cutanea tarda in this patient population (1). Although it is quite rare, Grover's disease (GD) has been reported in several patients with renal insufficiency, but only once in a renal transplant recipient (2). The disease follows three patterns: persistently pruritic, transient eruptive, or a chronic asymptomatic course (3)...
September 2019: Acta Dermatovenerologica Croatica: ADC
https://read.qxmd.com/read/31531628/bartonella-henselae-bacteremia-diagnosed-post-mortem-in-a-myelodysplastic-syndrome-patient
#14
Marina Rovani Drummond, Lorena Visentainer, Amanda Roberta de Almeida, Rodrigo Nogueira Angerami, Francisco Hideo Aoki, Paulo Eduardo Neves Ferreira Velho
This study involves a 49-year-old male, who for three years suffered with a myelodysplastic syndrome and who needed frequent blood transfusions. One day following a transfusion, he presented fever and abdominal pain. The fever became persistent and only improved temporarily with two cycles of intravenous ciprofloxacin. Nearly 120 days after beginning the second cycle of treatment, he had experienced a weight loss of 16 kg and recurring fever. Screening for fever of unknown origin was conducted, including Bartonella infection...
September 12, 2019: Revista do Instituto de Medicina Tropical de São Paulo
https://read.qxmd.com/read/31531611/fever-of-unknown-origin-a-literature-review
#15
REVIEW
Leonardo Fernandes E Santana, Mateus de Sousa Rodrigues, Marylice Pâmela de Araújo Silva, Rodrigo José Videres Cordeiro de Brito, Jandir Mendonça Nicacio, Rita Marina Soares de Castro Duarte, Orlando Vieira Gomes
Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world and can be associated with a myriad of differential diagnoses. It is defined as axillary temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or three outpatient visits. The main etiologies are: infectious, neoplastic, and rheumatic. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case...
September 12, 2019: Revista da Associação Médica Brasileira
https://read.qxmd.com/read/31522489/role-of-bone-marrow-examination-in-the-evaluation-of-infections-clinico-hematological-analysis-in-a-tertiary-care-centre
#16
Vijay Kumar, Akanksha Bhatia, Garima Baweja Madaan, Sadhna Marwah, A S Nigam
Objective: Bone marrow examination (BME) is an important modality for investigation of case of pyrexia of unknown origin (PUO). However, its yield in the diagnosis of infections has not been extensively studied and its role has not been well established. The aim of the study was to investigate the usefulness of BME and to evaluate the etiological and clinico-hematological profile in cases of bone marrow infections. Material and Method: This was a retrospective study where bone marrow cases were retrieved and a review of bone marrow findings with an infectious etiology from July 2014 to June 2018 was done...
July 31, 2019: Türk Patoloji Dergisi
https://read.qxmd.com/read/31492731/a-case-of-fever-of-unknown-origin-and-recurrent-hospital-admissions-in-a-cardiac-patient-emergence-of-enterobacter-cloacae
#17
Syed Emir Irfan Wafa, Raheel Ahmed, Kay Teck Ling, Peter Carey
A 72-year-old gentleman with significant cardiac history and a pacemaker in situ initially presented to the emergency department 5 days after he had his pacemaker-unit batteries changed. He had deranged vital signs, productive cough and fever. His chest plain radiograph did not show evidence of infection; however, he had right basal crackles on auscultation, which suggested a lower respiratory tract infection. He was treated with intravenous co-amoxiclav and supportive therapy, which led to his improvement...
September 5, 2019: BMJ Case Reports
https://read.qxmd.com/read/31454368/usefulness-of-fdg-pet-ct-in-the-management-of-tuberculosis
#18
Adrián Sánchez-Montalvá, Marta Barios, Fernando Salvador, Ana Villar, Teresa Tórtola, Daniel Molina-Morant, Carles Lorenzo-Bosquet, Juan Espinosa-Pereiro, Israel Molina
BACKGROUND: The aim of our study is to describe the FDG-PET/CT findings in patients with tuberculosis and to correlate them with the patient's prognosis. METHODS: We retrospectively collected data from patients with tuberculosis, who had an FDG-PET/CT performed prior to treatment initiation from 2010 to 2015. RESULTS: Forty-seven out of 504 patients with active tuberculosis diagnosis (9.33%) underwent an FDG-PET/CT. The reasons for performing the FDG-PET/CT were: characterization of a pulmonary nodule (24; 51...
2019: PloS One
https://read.qxmd.com/read/31423947/antimicrobial-de-escalation-in-adult-hematopoietic-cell-transplantation-recipients-with-febrile-neutropenia-of-unknown-origin
#19
Megan M Petteys, Ekaterina Kachur, Kelly E Pillinger, Jiaxian He, Edward A Copelan, Zainab Shahid
BACKGROUND: The optimal duration of empiric antimicrobial therapy in febrile neutropenia of unknown origin is unclear. This study evaluated outcomes in autologous and allogeneic hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin who received early de-escalation of broad-spectrum antimicrobials prior to hematopoietic recovery versus those who continued broad-spectrum antimicrobials until hematopoietic recovery. METHODS: A single-center, retrospective study assessed hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin...
August 18, 2019: Journal of Oncology Pharmacy Practice
https://read.qxmd.com/read/31416435/splenic-abscesses-as-a-first-manifestation-of-crohn-s-disease-a-case-report
#20
D F Bavaro, G Ingravallo, F Signorile, F Fortarezza, F Di Gennaro, G Angarano, A Saracino
BACKGROUND: Splenic nodules are uncommon entities that occur rarely in the general population. Although an infectious etiology (primarily bacteria, followed by mycobacteria) is usually found, noninfectious diseases, including malignancies and autoimmune disorders, can also be involved. For instance, in course of inflammatory bowel diseases (IBDs), in particular Crohn's Disease, aseptic splenic abscesses have been reported in patients with a long history of illness, or in those unresponsive to medical treatments, while are only anecdotally reported in the early phase of the disease...
August 15, 2019: BMC Gastroenterology
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