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The efficacy of functional endoscopic sinus surgery in the evolution of fever of unknown origin in ICU patients

PADUA, Francini G. M.; BEZERRA, Thiago F. P.; VOEGELS, Richard L.; BENTO, Ricardo F.
Fonte: INFORMA HEALTHCARE Publicador: INFORMA HEALTHCARE
Tipo: Artigo de Revista Científica
ENG
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95.78%
Conclusion: Functional endoscopic sinus surgery (FESS) was found to be effective in treating fever of unknown origin (FUO) in intensive care unit (ICU) patients with rhinosinusitis, with 62% of patients showing improvement within 5 days of the procedure. Objective: To correlate improvement in FUO with FESS drainage of the paranasal sinuses. Methods: Fifty patients that developed FUO during ICU stay, with CT findings suggestive of rhinosinusitis, and showed no improvement in fever after clinical treatment underwent FESS for drainage of the paranasal sinuses and were evaluated for postoperative improvement of fever. Results: The study sample consisted of 50 patients (74% of whom were male, mean age 48.1 years). The most frequent diagnoses at ICU admission were tetanus, pulmonary disease, and cardiovascular disease. In all, 68% of patients underwent nasogastric or enteral intubation. CT scanning most commonly showed involvement of the sphenoid sinus. In 54% of cases, sinusitis was bilateral and extended throughout the maxillary, ethmoidal, and sphenoidal sinuses. Sinusectomy was performed in all patients, and pathological secretion in the paranasal sinuses was seen in 52% of patients during surgery. Gram-negative bacteria were the most commonly isolated organisms...

Unusual clinical presentation of anaplastic large cell lymphoma

Campos, Fernando Peixoto Ferraz de; Zerbini, Maria Claudia Nogueira; Simoes, Angelica Braz; Lovisolo, Silvana Maria; Fonseca, Leonardo Gomes da; Laborda, Lorena Silva; Felipe-Silva, Aloisio
Fonte: Hospital Universitário da USP; São Paulo Publicador: Hospital Universitário da USP; São Paulo
Tipo: Relatório
ENG
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95.76%
Anaplastic large cell lymphoma (ALCL), a well-recognized entity, presents a varied clinical picture and epidemiological characteristics associated with the expression of the anaplastic lymphoma kinase (ALK) protein. When classic symptoms are present (weight loss, fever, and night sweats) and combine with enlarged and easily accessible peripheral lymph nodes, diagnosis is not that difficult. But when the clinical presentation is nonspecific, a tough diagnostic task is required. HIV infection is highly associated with neoplastic disorders—mainly with those of hematological origin. However, ALCL is exceptionally associated with HIV infection, and the few reported cases are ALK– ALCL. The authors report two cases of ALK+ ALCL with the unusual clinical presentation: one is associated with the HIV infection and the other presents as a fever of unknown origin (FUO) without peripheral lymphadenopathy. The latter was autopsied and was characterized by nodal and extra nodal involvement. The authors call attention to the plurality of clinical presentation of this group of lymphomas, and the early indication of bone marrow examination in cases of an FUO with elevated hepatic enzymes and lactic dehydrogenase.

Localized hepatic tuberculosis presenting as fever of unknown origin

Ferrari,Teresa Cristina Abreu; Couto,Carolina Mundim; Vilaça,Tatiane Silva; Xavier,Marcelo Antônio Pascoal
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2006 EN
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Localized hepatic tuberculosis is a rare clinical form of tuberculosis infection; it has signs and symptoms related only to hepatic injury, with minimal or no extrahepatic involvement. It frequently presents as a non-specific syndrome, with systemic manifestations, which can sometimes result in a diagnostic dilemma. A high index of suspicion is required and a definitive diagnosis can be very difficult. We report a case of localized hepatic tuberculosis that presented as fever of unknown origin.

Evaluation of the incidence of occult bacteremia among children with fever of unknown origin

Berezin,Eitan Naaman; Iazzetti,Marco Antonio
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2006 EN
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105.78%
We reviewed the incidence of occult bacteremia, to identify the most frequent etiological agents of bacteremias in otherwise healthy children from one month to 10 years old, who had fever of unknown origin attended at the emergency ward of an urban, university-affiliated pediatric referral center. This was a retrospective medical record review, evaluating children with fever. Data were collected from the initial visit, when blood cultures, hematological properties and hemosedimentation rates were examined. Fever was considered as the highest temperature assessed in the hospital or reported by the responsible adult. Occult bacteremia was discovered in 1.4% of the 1,051 children evaluated, and the most common etiologic agent was Streptococcus pneumoniae. Total leukocyte count and blood sedimentation rates greater than 30 mm³ were not predictive factors for occult bacteremia. Fever greater than 39ºC was the most important factor for predicting occult bacteremia (P<0.001). The presence of occult bacteremia was significantly correlated with patient hospitalization.

Fever of unknown origin: attempts to isolate L-forms and other aberrant bacterial forms.

Gleckman, R; Esposito, A; Madoff, S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/1977 EN
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An investigation was conducted with 65 selected febrile patients, 33 of whom fulfilled in all respects the classic criteria of "fever of unknown origin." Clinical evaluation included extensive radiological and immunological testing. Multiple blood cultures were examined by conventional methods in control studies. In addition, venous blood was cultured in a variety of hyperosmolar media using the special techniques used to detect L-forms and other cell wall-defective bacterial forms. By the extensive methods used, no bacterial forms were isolated. The use of media containing osmotic stabilizers did not detect L-forms or other aberrant bacterial forms, nor did it contribute to the determination of the etiology of fever of unknown origin in these patients.

Splenic tuberculosis presenting as fever of unknown origin with severe neutropenia

Azzam, Nahla A
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 18/06/2013 EN
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85.8%
Fever of undetermined origin always poses a challenging problem to the physician. Tuberculosis is an important health problem in developing countries. It is mostly seen in immune-compromised patients. And it is one of the common causes of fever of unknown origin. I am reporting a case of a splenic tuberculosis in 48 years old male who is not known of any immune deficiency state, he was presented with 3 weeks history of fever and found to have severe neutropenia and with negative work up for all hematological, rheumatological and malignant causes. A computerized tomography scan of the abdomen confirmed splenic enlargement with multiples hypo dense lesions consist with either splenic infection or splenic lymphoma so exploratory splenectomy was performed. Histological examination revealed granulomatouse inflammation with numerous acid fast bacilli consist with tuberculosis. He was started on four anti-tuberculouse drugs. in less than one week his fever subside with normalization of his neutrophilic count

Celiac Disease Presenting as Fever of Unknown Origin

Cooney, Megan J.; El-Matary, Wael
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
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85.82%
Celiac disease (CD) is a common autoimmune enteropathy that occurs, in affected individuals, with exposure to gluten in the diet and improves with removal of dietary gluten. Although CD is readily considered in patients with classical presentations of the disease, atypical manifestations may be the only presenting symptoms. We present a case of CD in a 16-year-old female presenting as fever of unknown origin, which has not been reported previously. The postulated mechanism for fever in CD and the importance of clinicians having a low threshold for considering CD in the differential diagnosis of fever of unknown origin and other enigmatic clinical presentations is discussed.

Changing pattern of infectious etiology of fever of unknown origin (FUO) in adult patients in Ahvaz, Iran

Alavi, Seyed-Mohammad; Nadimi, Mohammad; Zamani, Gholam Abbas
Fonte: Babol University of Medical Sciences Publicador: Babol University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
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95.69%
Background: Although infectious diseases are the most common sources for the fever of unknown origin (FUO), but the spectrum of infectious diseases is changing overtime. The purpose of the study was to define the clinical spectrum and changing the pattern of FUO.

Fever of unknown origin successfully treated by oren-gedoku-to (huanglian-jie-du-tang)

Tanaka, Koichiro; Nara, Kazuhiko; Nishimura, Tetsuya; Serizawa, Keiko; Miyazaki, Taito; Urita, Yoshihisa; Miura, Oto
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 07/10/2013 EN
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85.79%
Oren-gedoku-to is a traditional medicine used for treating inflammatory conditions and is given by prescription in Japan, People’s Republic of China, and Korea. Its anti-inflammatory effect is related to the arachidonate cascade and inhibition of cyclo-oxygenase, but research on other anti-inflammatory pathways is ongoing. We report a case of fever of unknown origin in a 33-year-old woman. The possibility of infection due to human immunodeficiency virus, autoimmune, neoplastic, or other disease was examined and excluded. Oren-gedoku-to was successfully used to treat her symptoms and may thus be a suitable treatment for patients with undiagnosed fever of unknown origin

Clinical profile of classical Fever of unknown origin (FUO)

Mir, Tanveer; Nabi Dhobi, Gulam; Nabi Koul, Ajaz; Saleh, Tajamul
Fonte: Babol University of Medical Sciences Publicador: Babol University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
95.69%
Background: The etiology of fever of unknown origin (FUO) may differ from different countries. This study was conducted to evaluate the etiology of FUO in patients attending SKIMS, a tertiary care teaching hospital, at Srinagar, Kashmir, India.

Fever of unknown origin: report of 107 cases in a university hospital

Yu, Kang-Kang; Chen, Sheng-Sen; Ling, Qing-Xia; Huang, Chong; Zheng, Jian-Ming; Cheng, Qi; Li, Ning; Chen, Ming-Quan; Shi, Guang-Feng
Fonte: e-Century Publishing Corporation Publicador: e-Century Publishing Corporation
Tipo: Artigo de Revista Científica
Publicado em 15/12/2014 EN
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85.79%
Fever of unknown origin (FUO) is a challenging problem in clinical practice. Evaluation of patient’s characteristics may illustrate the etiologies of FUO. In present study, 107 patients with FUO hospitalized in our inpatient department between 2010 and 2011 were investigated. The median age of the patients was 48 years (15-94). The median fever duration was 8.5 weeks (3-104). The median hospital stay was 8.5 days (1-51). Etiologies of FUO were identified as follows: infectious diseases 32 (29.9%), malignancies 19 (17.8%), inflammatory rheumatic diseases 18 (16.8%), and miscellaneous diseases 15 (14.0%). In 23 (21.5%) patients, the diagnosis remained unclear. Infection group had relative shorter average fever duration and hospital stay than other groups. Shortened mean fever duration was observed in geriatric age group. In conclusion, as the most common cause of FUO in the present study, infectious cases had relative shorter average fever duration and hospital stay, and geriatric patients had shortened average fever duration as well.

Adult-onset Still disease as the cause of fever of unknown origin.; Doença de still do adulto como causa de síndrome febril indeterminado.

Diogo, Marco; Serviço Medicina II, Hospital São Marcos, Braga.; Soares, João; Pimentel, Teresa; Ferreira, Adelina
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 22/10/2010 POR
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Fever of unknown origin remains a diagnostic challenge with up to 50% of unexplained cases. Adult-onset Still disease typically present high fever, arthralgia, rash, pharyngitis and serositis, lymphadenopathy and hepatosplenomegaly, inflammatory markers and hepatic enzymes elevation and negative immunological study. The authors present a 46-year old man with previous admissions for fever of unknown origin with a 3-week history of fever and systemic symptoms. The study disclosed anaemia, inflammatory markers and hepatic enzymes elevation, splenomegaly and negative serological and immunological studies. The patient posteriorly presented polyarthralgias and cutaneous rash. The introduction of corticotherapy resolved symptoms and laboratories alterations. Adult-onset Still disease is a heterogeneous and rare disease and the lack of serologic markers as a true gold standard makes diagnosis difficult.; Fever of unknown origin remains a diagnostic challenge with up to 50% of unexplained cases. Adult-onset Still disease typically present high fever, arthralgia, rash, pharyngitis and serositis, lymphadenopathy and hepatosplenomegaly, inflammatory markers and hepatic enzymes elevation and negative immunological study. The authors present a 46-year old man with previous admissions for fever of unknown origin with a 3-week history of fever and systemic symptoms. The study disclosed anaemia...

Large vessel vasculitis in a patient with fever of unknown origin.; Vasculite de grandes vasos em doente com febre de origem indeterminada.

Mesquita, Joana; Serviço de Medicina Interna, Hospital de São João, Porto.; Pereira, S
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 31/12/2009 POR
Relevância na Pesquisa
85.83%
Fever of unknown origin (FUO) is a challenging diagnosis. Recently, 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) has emerged as an useful exam to its diagnosis. The authors present a case of a 64-years-old woman with an aortic mechanical valve that was admitted to the internal medicine department because of fever, weakness and weight loss of 2 months duration. Her physical examination was unremarkable. Laboratory findings showed microcytic anemia, no leukocytosis, and elevated C-reactive protein and erythrocyte sedimentation rate. Microbiology, immunology and imaging studies were normal. A FDG-PET was performed, which showed 18F-FDG uptake in aorta and its branches arterial wall. Treatment with corticosteroids was started with good response. This exam, although not sensitive for temporal arteritis when only smaller vessels are involved, permits the diagnosis of large vessel vasculitis with involvement of arteries that can not be biopsied.; Fever of unknown origin (FUO) is a challenging diagnosis. Recently, 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) has emerged as an useful exam to its diagnosis. The authors present a case of a 64-years-old woman with an aortic mechanical valve that was admitted to the internal medicine department because of fever...

Das Muckle-Wells-Syndrom als Differentialdiagnose von unklarem Fieber und Untersuchung klinischer Einflussgrößen auf die Ausprägung der Krankheitsaktivität von Muckle-Wells-Syndrom Patienten; Muckle-Wells-Syndrome as a differential diagnosis of fever of unknown origin and risk factors of severe Muckle-Wells-Syndrome

Reeß, Fabian
Fonte: Universität Tübingen Publicador: Universität Tübingen
Tipo: Dissertation; info:eu-repo/semantics/doctoralThesis
DE_DE
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95.81%
Einleitung: Als Ursache für Fieber unklarer Genese (FUO) definierten Petersdorf und Beeson 1961 folgende Kriterien: 1) Fieberdauer von mindestens 3 Wochen mit, 2) Temperaturen über 38,3°C und 3) nach 1 Woche gründlicher Untersuchung keine sichere Diagnose. Das Muckle-Wells-Syndrom (MWS) ist eine Differentialdiagnose für FUO. Hierbei handelt es sich um eine autoinflammatorische Erkrankung deren Ursache in Mutationen im NLRP3 Gen auf Chromosom 1q44 liegt und zu einer übermäßigen Ausschüttung von Interleukin-1 führt. Klinische Ausprägungen zeigen sich in Fieberschüben, urticariellen Exanthemen, Arthralgien, Arthritiden, Konjunktivitiden, bis hin zum Auftreten einer Innenohrschwerhörigkeit und einer Amyloidose. Zusammen mit dem Familial Cold Autoinflammatory Syndrome (FCAS) und dem Neonatal Onset Multiinflammatory Syndrome (NOMID) gehört das MWS zu den Cryopyrin-Associated Periodic Syndrome (CAPS). Es ist unbekannt, ob demografische, klinische oder laborchemische Merkmale zum Zeitpunkt der Diagnosestellung Hinweise auf den Krankheitsverlauf geben können. Ziel der Studie war 1) FUO Patienten mit MWS Patienten zu vergleichen und dabei klinische und laborchemische Merkmale zu analysieren und ein Risikoprofils für das Vorliegen eines MWS zu erstellen 2) die Erstellung eines Hochrisikoprofils für den Krankheitsaktivitätsverlauf des MWS. Patienten und Methoden: Es wurde eine retrospektive...

FEVER OF UNDETERMINED ORIGIN IN PATIENTS WITH THE ACQUIRED IMMUNODEFICIENCY SYNDROME IN BRAZIL: REPORT ON 55 CASES

LAMBERTUCCI,J. Roberto; RAYES,Abdunnabi A.M.; NUNES,Frank; LANDAZURI-PALACIOS,Jairo Enrique; NOBRE,Vandack
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/1999 EN
Relevância na Pesquisa
105.78%
The medical records of patients with AIDS admitted to a general hospital in Brazil from 1989 to 1997 were reviewed retrospectively with the aim at defining the frequency and etiology of fever of undetermined origin (FUO) in HIV-infected patients of a tropical country and to evaluate the usefulness of the main diagnostic procedures. 188 (58.4%) out of 322 patients reported fever at admission to hospital and 55 (17.1%) had FUO. Those with FUO had a mean CD4+ cell count of 98/ml. A cause of fever was identified for 45 patients (81.8%). Tuberculosis (32.7%), Pneumocystis carinii pneumonia (10.9%), and Mycobacterium avium complex (9.1%) were the most frequent diagnoses. Other infectious diseases are also of note, such as cryptococcal meningitis (5.5%), sinusitis (3.6%), Salmonella-S. mansoni association (3.6%), disseminated histoplasmosis (3.6%), neurosyphilis (1.8%), and isosporiasis (1.8%). Four patients had non-Hodgkin's lymphoma (7.3%). We conclude that an initial aggressive diagnostic approach should be always considered because biopsies (lymph node, liver and bone marrow) produced the highest yield in the diagnosis of FUO and the majority of the diagnosed diseases are treatable. The association of diseases is common and have contributed to delay the final diagnosis of FUO in most cases. In our study area the routine request of hemocultures for Salmonella infection and the investigation of cryptococcal antigen in the serum should be considered.

Advanced Erosive Gout as a Cause of Fever of Unknown Origin

Kato, Mikiro; Oishi, Yuta; Inada, Makoto; Tokuda, Yasuharu
Fonte: The Korean Academy of Family Medicine Publicador: The Korean Academy of Family Medicine
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
95.79%
A 61-year-old man was referred to our hospital due to a 3-month history of fever of unknown origin, and with right knee and ankle joint pains. At another hospital, extensive investigations had produced negative results, including multiple sterile cultures of blood and joint fluids, and negative autoantibodies. His serum uric acid level was not elevated. However, after admission to our hospital, we performed right knee arthrocentesis, which revealed uric acid crystals. These findings, combined with the results of imaging tests, which showed joint degeneration, led to a diagnosis of advanced erosive gout. After receiving a therapeutic non-steroidal anti-inflammatory drug and a maintenance dose of colchicine for prophylaxis against recurrence, the patient's symptoms subsided and did not return. Advanced erosive gout should be considered a possible cause of fever of unknown origin and diagnostic arthrocentesis should be performed in patients with unexplained arthritis.

A case of giant hemangioma of the liver presenting with fever of unknown origin.

Lee, C. W.; Chung, Y. H.; Lee, G. C.; Kim, J. Y.; Lee, J. S.
Fonte: Korean Academy of Medical Sciences Publicador: Korean Academy of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em /04/1994 EN
Relevância na Pesquisa
95.84%
A 37 year-old-woman was admitted to the hospital because of 15 days' duration of continuous fever. Routine studies for detection of fever foci were negative. Imaging studies revealed giant hemangioma of the liver with central thrombosis. The fever persisted for a period of 4 weeks, and subsided after conservative management. We report a case of hepatic hemangioma presenting with fever of unknown origin. The condition is very rare, but should be regarded as one of the causes of fever of unknown origin.

FDG PET-CT in the Diagnosis of Takayasu Arteritis Presenting as Fever of Unknown Origin: A Case Report

Kim, Joohae; Oh, Myoung-don
Fonte: The Korean Society of Infectious Diseases and Korean Society for Chemotherapy Publicador: The Korean Society of Infectious Diseases and Korean Society for Chemotherapy
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
95.79%
Takayasu arteritis is a chronic vasculitis involving the large vessels. At diagnosis, ischemic symptom are usually present in the affected vessels. However, fever of unknown origin (FUO) is rare as an initial presentation and renders the condition difficult to diagnose. In this case report, we describe a patient who presented with a fever of unknown origin. A 68-year-old female was diagnosed with Takayasu arteritis after fluorodeoxyglucose (FDG) positron-emission tomography-computed tomography (PET-CT) was performed at the prepulseless stage. FDG PET-CT can assist in the early diagnosis of Takayasu arteritis patients with FUO and can improve the prognosis of such patients.

Unusual clinical presentation of anaplastic large cell lymphoma

Campos, Fernando Peixoto Ferraz de; Zerbini, Maria Claudia Nogueira; Felipe-Silva, Aloisio; Simões, Angélica Braz; Lovisolo, Silvana Maria; Fonseca, Leonardo Gomes da; Laborda, Lorena
Fonte: Universidade de São Paulo. Hospital Universitário Publicador: Universidade de São Paulo. Hospital Universitário
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 31/03/2014 ENG
Relevância na Pesquisa
95.76%
Anaplastic large cell lymphoma (ALCL), a well-recognized entity, presents a varied clinical picture and epidemiological characteristics associated with the expression of the anaplastic lymphoma kinase (ALK) protein. When classic symptoms are present (weight loss, fever, and night sweats) and combine with enlarged and easily accessible peripheral lymph nodes, diagnosis is not that difficult. But when the clinical presentation is nonspecific, a tough diagnostic task is required. HIV infection is highly associated with neoplastic disorders—mainly with those of hematological origin. However, ALCL is exceptionally associated with HIV infection, and the few reported cases are ALK– ALCL. The authors report two cases of ALK+ ALCL with the unusual clinical presentation: one is associated with the HIV infection and the other presents as a fever of unknown origin (FUO) without peripheral lymphadenopathy. The latter was autopsied and was characterized by nodal and extra nodal involvement. The authors call attention to the plurality of clinical presentation of this group of lymphomas, and the early indication of bone marrow examination in cases of an FUO with elevated hepatic enzymes and lactic dehydrogenase.

Fiebre de origen desconocido como forma de presentación atípica de mieloma múltiple: Caso clínico

Ernst,Daniel; Sanhueza A,Luis; Rojas,Luis  ; Aizman,Andrés  
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2009 ES
Relevância na Pesquisa
85.85%
Fever of unknown origin (FUO) can be caused by tumors, especially those arising from the hematopoietic system. Multiple myeloma can also cause fever but it is not a common cause of fever of unknown origin. We report a 53 year-old man presenting with fever lasting eight weeks. An extensive study for common causes of FUO was negative. The appearance of hypercalcemia and proteinuria during the evolution suggested the presence of a multiple myeloma, that was confirmed with a bone marrow biopsy. Thalidomide and dexametasone were prescribed with resolution of fever.