scholarly journals Pyrexia of unknown origin associated with a non-infected vaginal shelf pessary

2020 ◽  
Vol 49 (6) ◽  
pp. 1110-1111
Author(s):  
Mathew Gilbert ◽  
Myra Laurenson ◽  
James Casson ◽  
Ali Alsawaf
Keyword(s):  
Unknown Origin ◽  
Additional Line ◽  
Pyrexia Of Unknown Origin ◽  
Reactive Protein ◽  
Source Of Infection ◽  
Vaginal Pessary ◽  
Intravenous Antibiotics ◽  
Chest X Ray ◽  
Urine Microscopy ◽  
Tomography Scan

Abstract An 82-year-old female was admitted with pyrexia and rigors. Bloods showed a raised C-reactive protein and she was commenced on empirical intravenous antibiotics. Chest X-ray, urine microscopy and computed tomography scan of the patient’s abdomen and pelvis did not demonstrate a source of infection, and blood cultures did not grow a microorganism. A collateral history was taken from the patient’s husband who raised concerns regarding her vaginal shelf pessary and it was therefore removed. Subsequently the patient’s fever subsided, her inflammatory markers improved and she was discharged 2 days later. We believe this is the first reported case of pyrexia secondary to a non-infected vaginal pessary, and may provide clinicians with an additional line of enquiry when presented with patients with pyrexia of unknown origin.

scholarly journals Mycoplasma Pneumonia: An Unrecognized Cause of Fever of Unknown Origin in an Adult

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Fatima Ali-Ahmed ◽  
Alexandra Halalau
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Source Of Infection ◽  
Left Ankle ◽  
Pulmonary Manifestations ◽  
Mycoplasma Pneumonia ◽  
History Of ◽  
Hilar Adenopathy ◽  
Chest X Ray ◽  
Tomography Scan

A 26-year-old female was admitted for fever of unknown origin (FUO), headaches, left ankle edema, and a lower extremity rash consistent with erythema nodosum. She had no respiratory symptoms or family history of autoimmune diseases. A chest X-ray was negative for pneumonia or hilar adenopathy. Extensive autoimmune workup was negative. A chest, abdomen, and pelvis computed tomography scan was unremarkable and laboratory studies revealed no source of infection. On hospital day 5, the patient developed a mild productive cough. Her Mycoplasma pneumonia (MP) IgM was high, confirming the diagnosis of MP induced FUO. She was started on azithromycin 500 mg daily and within 24 hours her fevers and headaches resolved. Her left ankle edema and EN gradually improved over a course of a few weeks. This case report highlights the need for MP testing in the evaluation of fever of unknown origin, even in the absence of pulmonary manifestations.

scholarly journals Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz
Keyword(s):  
Vital Signs ◽  
C Reactive Protein ◽  
Nocardia Species ◽  
X Ray ◽  
Reactive Protein ◽  
Pulmonary Nocardiosis ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

scholarly journals Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

2018 ◽  
pp. bcr-2018-224955 ◽  
Author(s):  
Heather Lusby ◽  
Aaron Brooks ◽  
Eden Hamayoun ◽  
Amanda Finley
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Lower Quadrant ◽  
Reactive Protein ◽  
Source Of Infection ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Group A

A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients’ positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus. On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines. The patient was promptly treated with intravenous antibiotics and supportive care, and she acutely recovered. This case demonstrates a rare cause of PID and an atypical aetiology of severe sepsis. It illuminates the importance of considering PID as a source of infection for undifferentiated bacteraemia.

Colonic inflammatory myofibroblastic tumour presenting as ‘pyrexia of unknown origin’: report of a rare disease and its unique presentation.

2020 ◽  
Vol 13 (12) ◽  
pp. e236056
Author(s):  
Victor Vijay Coelho ◽  
Suraj Surendran ◽  
Beulah Roopavathana ◽  
Suchita Chase
Keyword(s):  
Unknown Origin ◽  
Inflammatory Myofibroblastic Tumour ◽  
Complete Excision ◽  
Pyrexia Of Unknown Origin ◽  
Positron Emission ◽  
Clinical Presentations ◽  
Disease Free ◽  
Tomography Scan ◽  
Rare Group

An intra-abdominal inflammatory myofibroblastic tumour (IMT) belongs to a rare group of diseases initially described as an inflammatory pseudotumour. Even though it is seen more often in children, its incidence in adults is even rarer. Clinical presentations can vary depending on its site and inherent tumour properties. The colon is an uncommon site for IMT and pyrexia of unknown origin (PUO) as its dominant clinical presentation is even rarer. A 27-year-old woman presented with PUO. She was evaluated under the department of internal medicine before undergoing an 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan. This showed an intensely enhancing descending colon mass. An image-guided biopsy of this lesion was reported as IMT. She underwent a left hemicolectomy and complete excision of the tumour, following which her symptoms resolved completely. The patient has been disease-free at a 6-month follow-up and is asymptomatic at 1 year.

scholarly journals Megaloblastic anemia: A common but often neglected cause of pyrexia of unknown origin

2015 ◽  
Vol 3 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Bushra Siddiqui ◽  
Divya Rabindranath ◽  
Shahbaz Habib Faridi ◽  
Azka Anees Khan ◽  
Sadaf Haiyat ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Antibiotic Treatment ◽  
Broad Spectrum ◽  
Marked Improvement ◽  
Megaloblastic Anemia ◽  
Unknown Origin ◽  
Epidemiological Data ◽  
Broad Spectrum Antibiotic ◽  
Pyrexia Of Unknown Origin ◽  
Intravenous Antibiotics

AbstractObjective: The objective was to study megaloblastic anemia as a cause of pyrexia of unknown origin (PUO). Materials and Methods: We conducted a study on 15 patients of megaloblastic anemia associated with fever, attending our hospital clinics over a period of 6 months. Results: While 11 patients had symptoms suggesting foci of infection and responded well to intravenous antibiotics, 4 patients had neither any evidence of infection nor responded with empirical broad spectrum antibiotic treatment. They were treated with vitamin B12/folate therapy which led to marked improvement in fever within 48 h. Presenting complaints of the patients and severity/duration of fever along with other epidemiological data were also studied in each case. Conclusion: The present study led us to conclude that megaloblastic anemia forms an important and reversible cause of fever and should be ruled out in all patients presenting with PUO. This knowledge would help the physicians in adequate and timely management of these patients.

Choking as a cause of negative pressure pulmonary oedema (NPPE) in an older adult

2020 ◽  
Author(s):  
Bradley Lonergan ◽  
Cerys Morgan ◽  
Yasser Al-Raweshidy ◽  
Ravneeta Singh
Keyword(s):  
Pulmonary Oedema ◽  
Negative Pressure ◽  
Her Family ◽  
Reactive Protein ◽  
Negative Pressure Pulmonary Oedema ◽  
Intravenous Antibiotics ◽  
Swallowing Difficulties ◽  
Chest X Ray ◽  
Risk Of Aspiration

Abstract An 86-year-old female presented to the Emergency Department (ED) in respiratory distress after choking on a sandwich at home. Her family had noticed that she had had difficulty during and coughing after swallowing for several months. Her initial chest x-ray showed diffuse alveolar infiltrates in both lungs and blood tests showed normal white cells and C-Reactive Protein (CRP). She was started on intravenous antibiotics for presumed aspiration pneumonia and received 15 L of oxygen. However, the infiltration had dramatically improved, both radiologically and clinically, within 24 hours. She was diagnosed with negative pressure pulmonary oedema (NPPE) type 1 and made a rapid recovery. The Speech and Language Team diagnosed an impaired swallow and advised soft or bite-sized suitable foods. We discussed the ongoing risk of aspiration and long-term feeding options with the patient’s family. We agreed on a conservative plan for ‘risk feeding’, given her frailty and co-morbidities, and began discussions on ceilings of care. This case aims to raise awareness of NPPE so that it can be diagnosed, investigated and treated promptly. Although seen most commonly by intensivists and anaesthetists, it is relevant to those on the acute medical take and geriatricians managing patients with swallowing difficulties.

scholarly journals Clinical Presentation and Management of a Dinutuximab Beta Extravasation in a Patient with Neuroblastoma

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 91
Author(s):  
Michael Launspach ◽  
Marita Seif ◽  
Theresa M. Thole ◽  
Patrick Jesse ◽  
Joachim Schulz ◽  
...  
Keyword(s):  
High Risk ◽  
Neuroblastoma Cells ◽  
Drug Application ◽  
Immunocompromised Host ◽  
Laboratory Diagnostics ◽  
Chemotherapy Drugs ◽  
Reactive Protein ◽  
Intravenous Antibiotics ◽  
Inflammatory Toxicity ◽  
Bacterial Superinfection

Extravasation can present serious accidental complication of intravenous drug application. While monoclonal antibodies do not show the necrotic potential of cytotoxic chemotherapy drugs, considerable inflammatory toxicity can occur, necessitating standardized operating procedures for the management of their extravasation. Here, we report the clinical course and management of dinutuximab beta extravasation in a 3-year-old child. Dinutuximab beta is a chimeric monoclonal antibody targeting the GD2 disialoganglioside on the surface of neuroblastoma cells that has in recent years gained significant importance in the treatment of high-risk neuroblastoma, now contributing to both first- and second-line therapy protocols. The dinutuximab beta extravasation reported here occurred when the patient received the antibody cycle as a continuous infusion over a 10-day period after haploidentical stem cell transplantation for relapsed high-risk neuroblastoma. The extravasated dinutuximab beta caused local pain, swelling, and hyperemia accompanied by fever and an overall deterioration in the general condition. Laboratory diagnostics demonstrated an increase in C-reactive protein level and total white blood cell count. Clinical complication management consisted of intravenous fluid therapy, local dabbing with dimethyl sulfoxide (DMSO), analgesia with dipyrone, as well as application of intravenous antibiotics to prevent bacterial superinfection in the severely immunocompromised host. The patient considerably improved after six days with this treatment regimen and fully recovered by day 20.

scholarly journals E12. C-REACTIVE PROTEIN OF UNKNOWN ORIGIN

Rheumatology ◽  
2017 ◽  
Vol 56 (suppl_2) ◽  
Author(s):  
Kapil Halai ◽  
Ognjenka Savanovic-Abel
Keyword(s):  
Unknown Origin ◽  
C Reactive Protein ◽  
Reactive Protein

Postpartum pyrexia of unknown origin

2010 ◽  
Vol 20 (2) ◽  
pp. 57-62
Author(s):  
Margaret Ann Harper
Keyword(s):  
Unknown Origin ◽  
Pyrexia Of Unknown Origin
Sign in / Sign up

Export Citation Format

Share Document