RESUMO
Persistent undiagnosed fever remains a common problem in clinical practice. In a variable number of cases, no definitive diagnosis is made. This lack of a clear etiology indicates that certain disorders are not being detected despite the recently developed technology usually applied in this situation. On occasion, dental disease is one potential cause of persistent fever. Oral symptoms usually are not present, thus allowing the oral cavity to be overlooked during physical examination. We describe three patients with persistent fever due to dental disease and discuss the pathogenesis of this disease.
Assuntos
Febre de Causa Desconhecida/diagnóstico , Febre de Causa Desconhecida/microbiologia , Doenças Dentárias/complicações , Doenças Dentárias/microbiologia , Adulto , Antibacterianos/uso terapêutico , Feminino , Febre de Causa Desconhecida/tratamento farmacológico , Humanos , Infecções/diagnóstico , Infecções/microbiologia , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
PURPOSE: Pericardial effusion has been known to be a rare manifestation of giant cell arteritis. During the last six decades, only 24 cases have been cited in the literature. In this report, we describe the case of a patient presenting with nonspecific symptoms and development of pericardial effusion. PROCEDURES AND FINDINGS: A 71-year-old woman was admitted to the hospital with low-grade fever, exertion breathlessness, atypical diffuse muscular pain, and weight loss over a period of about 5 weeks. Pericardial effusion and giant cell arteritis were diagnosed by echocardiography and left temporal artery biopsy, respectively. Treatment with corticosteroids resulted in remarkable improvement of symptoms and complete remission of pericardial effusion. One year after admission, the patient remained in a stable good condition, under low steroid maintenance dosage. CONCLUSIONS: The diversity of clinical manifestations (such as pericardial effusion) in such a potentially severe disease should alert the physician to prompt diagnosis and treatment in view of impending irreparable vascular damages, even in cases in which the initial presentation is quite uncommon.
Assuntos
Arterite de Células Gigantes , Derrame Pericárdico , Corticosteroides/administração & dosagem , Idoso , Biópsia/métodos , Diagnóstico Diferencial , Ecocardiografia/métodos , Feminino , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/diagnóstico por imagem , Arterite de Células Gigantes/tratamento farmacológico , Arterite de Células Gigantes/patologia , Humanos , Derrame Pericárdico/complicações , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/tratamento farmacológico , Derrame Pericárdico/patologia , Artérias Temporais/diagnóstico por imagem , Artérias Temporais/patologiaRESUMO
Splenic abscess is an unusual condition, most often seen in immunocompromised patients. Splenic abscesses are due to aerobic and anaerobic bacteria, fungi and parasites, Staphylococcus aureus being the most common aetiological agent. We describe a case of splenic abscess in an alcoholic patient due to Staphylococcus lentus, a rare aetiology included in the microbiology of this disease.
Assuntos
Abscesso/microbiologia , Esplenopatias/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus/isolamento & purificação , Idoso , Alcoolismo/microbiologia , Humanos , MasculinoRESUMO
OBJECTIVE: To report a case of fever of unknown origin in a patient with carcinoma of the colon but without gastrointestinal symptoms. CLINICAL PRESENTATION AND INTERVENTION: A 65-year-old man presented with a long-standing fever (of 38 degrees C, about two months' duration), night sweats, fatigue, malaise and anxiety. General physical examination including rectum, radiographic examinations of the chest, abdomen and bones (including ultrasonography and CT scanning) was normal. Biochemistry profile as well as other laboratory studies including blood, urine and stool cultures were normal except for erythrocyte sedimentation rate, which was 105 mm/h. A barium enema showed a rectosigmoid carcinoma. A left sigmoidal colectomy was performed. The patient recovered quickly and remained well for eight years postoperatively. CONCLUSION: This case shows that carcinoma of the colon should be included in the differential diagnosis of patients with fever of unknown origin.