[Leukopenia with unclear fever]. / Leukopenie mit unklarem Fieber.

We report on a 77-year-old male patient with neutropenic fever as a result of a newly diagnosed agranulocytosis. The patient was taking metamizole, which is a well known cause of agranulocytosis. The diagnosis of metamizole-induced agranulocytosis as an underestimated side-effect of metamizole could be confirmed by a bone marrow biopsy. The bone marrow and the blood count recovered completely after stopping the therapy with metamizole and administration of granulocyte colony-stimulating factor (G-CSF).

[Unclear tetraparesis under immunosupression]. / Unklare Tetraparese unter Immunsuppression.

We report a case of a 69-year-old man who developed tetraparesis and muscular pain under the therapy of prednisolone for several months. Diagnosis was sepsis due to pyomyositis with multiple septic pulmonary staphylococcus aureus abscesses. Antibiotic therapy with piperacillin and tazobactam resulted in a decrease of the inflammatory factors and improvement of the tetraparesis. Pyomyositis, common in tropical areas, is a suppurative infection of striated muscle. Immunodeficiency has been implicated in the development of pyomyositis in temperate climates.

[48-year-old female patient with Crohn's disease and new hematuria and proteinuria]. / 48-jährige Patientin mit bekanntem M. Crohn und neu aufgetretener Erythrozyturie sowie Proteinurie.

We report on a 48-year-old patient with Crohn's disease and left abdominal pain, who presented with hematuria and proteinuria. As reason we found a left renal vein thrombosis. This diagnosis was based on magnetic resonance imaging and doppler ultrasound. The incidence of thrombembolic complications in patients with chronic inflammatory bowel disease is increased, however renal vein thrombosis is a very rare complication of Crohn's disease. We started a conservative treatment with phenprocoumon. Thereafter the patient remained asymptomatic and the thrombus dissipated during follow-up.