背景:不明原因发热(FUO)提出了诊断挑战,通常需要系统的评估来揭示其难以捉摸的原因。本案例研究探讨了一名42岁的中国男性持续发烧的表现,肌肉疼痛,还有令人困惑的皮疹.
方法:患者的症状包括长时间发烧,发冷,肌肉疼痛,喉咙不适,有肺结核病史。最初诊断为上呼吸道感染和未指明的感染,随后进行抗生素治疗,然而发烧仍然存在,伴有皮疹加剧。
方法:广泛的诊断调查,包括实验室测试,影像学检查,皮肤镜检查,提供了宝贵的见解。患者表现出炎症标志物升高,肝脾肿大,淋巴结病,和肺结节。鉴别诊断包括成人发作的Still病和药物引起的超敏反应综合征。
方法:患者接受了一系列抗生素治疗,最初成功有限。在考虑自身免疫性病因后,引入了皮质类固醇,其次是环孢菌素。患者对这种免疫抑制疗法表现出阳性反应。
结果:进行了治疗调整,患者对皮质类固醇和环孢素的组合反应积极。他退烧了,和实验室标记标准化。出院后一个月,患者表现出持续改善。
结论:FUO病例通常需要多学科方法,考虑罕见和不常见的疾病。此案强调了彻底评估的重要性,专业之间的合作,以及对治疗反应的警惕监测。患者的独特表现强调需要考虑药物诱导的反应,即使症状偏离典型的疾病模式,突出了诊断和管理FUO的复杂性。
BACKGROUND: Fever of unknown origin (FUO) poses a diagnostic challenge, often requiring a systematic evaluation to uncover its elusive cause. This case study delves into the presentation of a 42-year-old Chinese male with persistent fever, muscle pain, and a perplexing rash.
METHODS: The patient\'s symptoms included a prolonged fever, chills, muscle pain, and throat discomfort, with a history of pulmonary tuberculosis. Initial diagnoses of upper respiratory infection and unspecified infection were followed by antibiotic treatments, yet the fever persisted, accompanied by an exacerbating rash.
METHODS: Extensive diagnostic investigations, including laboratory tests, imaging studies, and skin dermoscopy, provided valuable insights. The patient exhibited elevated inflammatory markers, hepatosplenomegaly, lymphadenopathy, and lung nodules. Differential diagnoses included adult-onset Still disease and drug-induced hypersensitivity syndrome.
METHODS: The patient received a series of antibiotic treatments, which initially had limited success. Upon considering an autoimmune etiology, corticosteroids were introduced, followed by cyclosporine. The patient exhibited a positive response to this immunosuppressive therapy.
RESULTS: Treatment adjustments were made, and the patient responded positively to a combination of corticosteroids and cyclosporine. His fever subsided, and laboratory markers normalized. One month after discharge, the patient showed continued improvement.
CONCLUSIONS: FUO cases often demand a multidisciplinary approach, considering rare and uncommon diseases. This case underscores the importance of thorough evaluation, collaboration between specialties, and vigilant monitoring of treatment responses. The patient\'s unique presentation emphasizes the need to consider drug-induced reactions, even when symptoms deviate from typical disease patterns, highlighting the complexities in diagnosing and managing FUO.