Juvenile Onset Still’s Disease Presenting as Pyrexia of Unknown Origin: A Case Report

Adult Still's disease is a recently recognised syndrome which is an important and often unrecognised cause of pyrexia of unknown origin. A knowledge of the clinical features of this disease may save patients with undiagnosed fever from prolonged and invasive investigations. The condition usually responds to conservative therapy with non-steroidal anti-inflammatory agents and bed rest, although in a minority of patients more toxic drugs may be required. The prognosis is usually good although long-term follow-up studies of these patients are small in number, and the most recent review sounds a warning as to the incidence of chronicity. Sufficient evidence now exists to identify Still's disease as a separate nosological entity in adults. It should be added to the ever-expanding list of causes of pyrexia of unknown origin.

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ADULT ONSET STILL’S DISEASE PRESENTING AS PYREXIA OF UNKNOWN ORIGIN

10.36106/ijsr/8525478 ◽

2021 ◽

pp. 43-44

Author(s):

Naim M Kadri ◽

Yash S Patel ◽

Pratvi V Vaishnav ◽

Smit R Patel

Keyword(s):

Young Male ◽

Unknown Origin ◽

Adult Onset Still’S Disease ◽

Adult Onset ◽

Still’S Disease ◽

Pyrexia Of Unknown Origin ◽

Still's Disease ◽

Sustained Effect ◽

Yamaguchi Criteria ◽

Adult Onset Still's Disease

Adult onset Still’s disease (AOSD) is a rare inammatory disease characterized by fever, arthralgia, rash, sore throat, lymphadenopathy, hepatomegaly and/or splenomegaly. It is a rare cause of pyrexia of unknown origin (PUO) and should be considered once the more common infectious, rheumatological and malignant causes have been excluded. This is usually a diagnosis of exclusion. Yamaguchi criteria can be used for diagnosis. Patients of AOSD show an excellent response to Non-steroidal anti-inammatory drugs (NSAIDs), however some may not have a sustained effect, in which case glucocorticoids have to be considered. Here’s a case of a young male patient who was evaluated for the cause of pyrexia of unknown origin.

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ADULT ONSET STILL'S DISEASE AS FEVER OF UNKNOWN ORIGIN - A CASE REPORT

10.47660/cbr.2020.16910 ◽

2021 ◽

Author(s):

Jéssica Tomps Corrêa ◽

Gabriela Ferreira Rocha ◽

Vinícius Shinoda Pereira ◽

Victor Gomes Rocha ◽

Erickson Gomes Gutierrez ◽

...

Keyword(s):

Case Report ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Adult Onset Still’S Disease ◽

Adult Onset ◽

Still’S Disease ◽

Still's Disease ◽

Adult Onset Still's Disease

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Aetiology of pyrexia of unknown origin in north India

Tropical Doctor ◽

10.1177/0049475520947907 ◽

2020 ◽

pp. 004947552094790

Author(s):

Ashok Kumar Pannu ◽

Rithvik Golla ◽

Savita Kumari ◽

Vikas Suri ◽

Pankaj Gupta ◽

...

Keyword(s):

Extrapulmonary Tuberculosis ◽

Age Groups ◽

Unknown Origin ◽

North India ◽

Adult Onset Still’S Disease ◽

Adult Onset ◽

Still’S Disease ◽

Pyrexia Of Unknown Origin ◽

Still's Disease ◽

Adult Onset Still's Disease

The aetiology of pyrexia of unknown origin (PUO) varies dramatically according to epidemiology. We studied the cause and spectrum of PUO in Indian adults. A total of 152 patients (112 prospectively and 40 retrospectively) met Petersdorf and Beeson's criteria. The diagnostic evaluation was guided by potentially diagnostic clues, based on a ‘step-wise’ approach. The five main categories, i.e. infectious, neoplastic, non-infectious inflammatory, miscellaneous and undiagnosed comprised 43.4%, 21.5%, 19.7%, 2.0% and 12.5%, respectively. The top three causes were tuberculosis (n = 43, 28.3%), lymphoma (n = 19, 12.5%) and adult-onset Still's disease (n = 12, 7.9%). Tuberculosis predominated in all age groups, and about 70% of cases had the extrapulmonary form, the most common being gastrointestinal. Hodgkin and non-Hodgkin lymphomas were equally distributed, but solid malignancies were uncommon. Adult-onset Still's disease was the second commonest cause in adults aged ≤ 40 years. Fever resolved spontaneously in 12/19 cases of undiagnosed cause. Extrapulmonary tuberculosis remains the most prevalent PUO in India.

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Leptospirosis presenting as severe cardiogenic shock: A case report

Journal of the Intensive Care Society ◽

10.1177/1751143718754993 ◽

2018 ◽

Vol 19 (4) ◽

pp. 351-353

Author(s):

E Forbat ◽

MJ Rouhani ◽

C Pavitt ◽

S Patel ◽

R Handslip ◽

...

Keyword(s):

Case Report ◽

Cardiogenic Shock ◽

Social History ◽

Rare Case ◽

Clinical Course ◽

Unknown Origin ◽

Case Presentation ◽

Pyrexia Of Unknown Origin ◽

Severe Cardiogenic Shock ◽

Infectious Illness

Background Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.

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